血清vaspin诊断非创伤性股骨头坏死的临床价值

目的 探讨内脏脂肪组织来源的丝氨酸蛋白酶抑制剂（visceral adipose tissue-derived serine protease inhibitor，vaspin）水平诊断非创伤性股骨头坏死（nontraumatic osteonecrosis of femoral head，NONFH）的临床价值。方法 选取2022年11月至2023年5月于临沂市人民医院住院治疗的NONFH患者77例纳入坏死组，同期76名于本院健康体检者纳入正常组。比较两组受试者的一般资料、坏死组不同临床特征患者的血清vaspin水平。绘制受试者操作特征曲线（receiver operating characteristic curve，ROC曲线）分析血清vaspin诊断NONFH的价值。结果 坏死组患者的血清vaspin水平显著低于正常组（P<0.05）。双侧髋部患病者的血清vaspin水平显著低于单侧髋部患病者（P<0.05）。股骨头塌陷患者的血清vaspin水平显著低于未塌陷患者（P<0.05）。患者血清vaspin水平随着国际骨循环研究学会（Association Research Circulation Osseous，ARCO）分期的增加而降低（P<0.05）。血清vaspin水平与ARCO分期、视觉模拟评分法评分均呈负相关（P<0.05），与Harris髋关节评分呈正相关（P<0.05）。ROC曲线显示血清vaspin诊断NONFH的曲线下面积为0.868（95%CI：0.813~0.923，P<0.001），敏感度为82.9%，特异性为75.3%。结论 vaspin可作为诊断NONFH的潜在血清标志物，血清vaspin水平随着NONFH病程的进展呈下降趋势。

Clinical value of serum vaspin in diagnosis of nontraumatic osteonecrosis of femoral head

Objective To investigate the clinical value of visceral adipose tissue-derived serine protease inhibitor (vaspin) level in the diagnosis of nontraumatic osteonecrosis of femoral head (NONFH). Methods A total of 77 NONFH patients hospitalized in Linyi People’s Hospital from November 2022 to May 2023 were included in necrotic group, and 76 healthy persons in our hospital during the same period were included in normal group. The general data of two groups were compared, and serum vaspin levels of patients with different clinical characteristics in necrotic group were compared. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of serum vaspin in NONFH. Results The serum vaspin level in necrotic group was significantly lower than that in normal group (P<0.05). Serum vaspin levels in patients with bilateral hip disease were significantly lower than those in patients with unilateral hip disease (P<0.05). Serum vaspin levels in patients with femoral head collapse was significantly lower than that in patients without femoral head collapse (P<0.05). The serum vaspin level decreased with the increase of Association Research Circulation Osseous (ARCO) stage (P<0.05). Serum vaspin level was negatively correlated with ARCO stage and visual analogue scale score (P<0.05), but positively correlated with Harris hip score (P<0.05). ROC curve showed that the area under the curve of serum vaspin for NONFH was 0.868 (95%CI: 0.813-0.923, P<0.001), sensitivity was 82.9%, specificity was 75.3%. Conclusion Vaspin can be used as a potential serum marker for the diagnosis of NONFH. With the progression of NONFH, the serum vaspin level tends to decrease.