外周血 Periostin表达水平与股骨头坏死塌陷进程的相关性研究

目的　研究外周血 Periostin表达与股骨头坏死塌陷进程的关系。方法　选取 2016年 8月 ~2019年 5月石家庄市人民医院收治的 110例股骨头坏死患者作为研究组。另纳入同期进行体检的 110例非股骨头坏死受试者作为对照组。测定受试者外周血中 Periostin水平。比较研究组和对照组 Periostin水平的差异；比较研究组患者不同病因及不同分期的 Periostin水平差异；比较研究组股骨头坏死塌陷前后的 Periostin水平差异；分析研究组患者外周血中 Periostin水平与病因及分期的相关性；采用 ROC曲线分析外周血中 Periostin在股骨头坏死塌陷的诊断效能。结果　研究组受试者外周血中 Periostin水平（ 0.65±0.10）显著高于对照组（ 0.65±0.10）,差异有统计学意义（ t=11.167，P<0.05）。研究组患者中国际骨循环研究会（ ARCO）不同分期组间比较差异具有统计学意义（ F=15.567，P<0.05），且Ⅲ期和Ⅳ期患者外周血中 Periostin水平（ 0.82±0.14，0.87±0.15）显著高于Ⅱ期患者（ 0.69±0.12），组间比较差异均具有统计学意义（均 P<0.05）。病因为酒精性、激素性、特发性及创伤性患者外周血中 Periostin水平比较差异无统计学意义（ F=0.563， P>0.05）。研究组患者股骨头坏死塌陷后（ 0.92±0.23）与塌陷前（ 0.67±0.11）相比外周血中 Periostin水平显著升高，差异有统计学意义（ t=6.465，P<0.05）。研究组 Periostin水平与 ARCO分期呈正相关（ r=0.563，P<0.05）。股骨头坏死塌陷患者外周血中 Periostin的 AUC及 95%CI分别为 0.841（95%CI，0.786~0.895，P<0.001），提示外周血中 Periostin对股骨头坏死塌陷诊断效能较高。结论　外周血中 Periostin表达与股骨头坏死塌陷有密切关系，股骨头坏死塌陷后外周血中 Periostin水平显著升高，对股骨头坏死塌陷具有一定的诊断价值。

Study on the Correlation between the Expression Level of Periostin in Peripheral Blood and the Collapse Process of FemoralHead Necrosis

Objective　To study the relationship between the expression of Periostin in peripheral blood and the collapse processof femoral head necrosis. Methods　Selected 110 patients with femoral head necrosis admitted to Shijiazhuang People’s Hospitalfrom August 2016 to May 2019 as the research group. In addition, 110 subjects with non-femoral head necrosis admitted to thehospital for physical examination at the same time were included as the control group. The Periostin protein level in the peripheralblood of the subjects was determined. Compared the difference of Periostin levels between the study group and the control group.Compared the differences in the levels of Periostin in the study group with different causes and different stages, and compared thedifference of Periodin levels before and after the collapse of femoral head necrosis in the study group. Analyzed the correlationbetween the level of Periostin in the peripheral blood of the study group and the etiology and stage, and analyzed the diagnosticefficacy of Periostin in peripheral blood for femoral head necrosis collapse. Results　The level of Periostin in the peripheralblood of the subjects in the study group(0.65±0.10) was significantly higher than that in the control group(0.65±0.10), thedifference was statistically significant (t=11.167，P<0.05). The difference between the ARCO stages of the study group wasstatistically significant (P<0.05), and the level of Periostin in the peripheral blood of patients with stage III and IV(0.82±0.14,0.87±0.15) was significantly higher than that of patients with stage II(0.69±0.12), and the differences between the groups werestatistically significant (P<0.05). The cause of the cause was that there was no statistically significant difference in the levels ofPeriostin in the peripheral blood of alcoholic, hormonal, idiopathic and trauma patients (P>0.05). After the femoral head necrosisof the study group collapsed, the level of Periostin in the peripheral blood(0.92±0.23) was significantly higher than that beforethe collapse(0.67±0.11),the difference was statistically significant (t=6.465，P<0.05). The level of Periodin in the study groupwas positively correlated with ARCO staging (r=0.563, P<0.05). The AUC and 95% CI of Periostin in peripheral blood ofpatients with femoral head necrosis collapse were 0.841 (95% CI, 0.786~0.895, P<0.001), and it suggesting that Periostin inperipheral blood had a higher diagnostic efficiency for femoral head necrosis collapse. Conclusion　The expression of Periostinin peripheral blood was closely related to the collapse of femoral head necrosis. After the collapse of femoral head necrosis, thelevel of Periostin in peripheral blood increases significantly, which has certain diagnostic value for femoral head necrosiscollapse.