非创伤性股骨头坏死检测血清NFE2L2的意义△

Significance of detection of serum NFE2L2 in nontraumatic necrosis of femoral head

摘要:

[目的]探讨非创伤性股骨头坏死（non-traumatic osteonecrosis of the femoral head, NONFH）患者检测血清中的核因子 E2 相关因子 2 （nuclear factor erythroid 2-related factor 2, NFE2L2） 的临床意义。[方法] 2021 年 8 月—2022 年 2 月在临沂市人民医院就诊的 78 例 NONFH 患者（坏死组）和 80 例健康对照者（正常组）纳入本研究，使用酶联免疫吸附法检测两组受试者血清中 NFE2L2 的水平。比较坏死组和正常组血清 NFE2L2 的水平差异。坏死组内按不同因素分层比较血清 NFE2L2 的水平差异。分析血清 NFE2L2 的水平与其他临床资料的相关性，绘制 ROC 诊断曲线评价血清 NFE2L2 诊断是否发生 NONFH 的意义。 [结果]坏死组血清 NFE2L2 水平显著高于正常组 [(289.2±130.7) pg/ml vs (173.7±75.7) pg/ml, P＜0.001]。坏死组内分层分析结果显示不同病因、不同侧别之间的血清 NFE2L2 的水平差异无统计学意义（P＞0.05），股骨头塌陷后的血清 NFE2L2 水平明显高于塌陷前 [(320.0±131.2) pg/ml vs (199.8±79.4) pg/ml, P=0.004]，随 ARCO 分期加重血清 NFE2L2 水平显著增加，分期间的差异具有统计学意义（P＜0.05）。相关性分析显示：血清 NFE2L2 水平与 ARCO 分期、VAS 评分均呈显著正相关（P＜0.05），与 Harris 评分呈显著负相关（P＜0.05）。ROC 曲线分析血清 NFE2L2 水平诊断 NONFH 的曲线下面积为 0.769。[结论]NONFH 患者血清 NFE2L2 水平显著升高，与 NONFH 的疾病严重程度相关，是诊断 NONFH 的潜在血清标志物。

Abstract:

[Objective] To explore the clinical significance of detection of serum nuclear factor erythroid 2-related factor 2 (NFE2L2) in nontraumatic osteonecrosis of the femoral head (NONFH). [Methods] A total of 78 patients with NONFH (the necrosis group) and 80 healthy controls (the normal group) admitted to Linyi People's Hospital from August 2021 to February 2022 were included in this study. Serum NFE2L2 levels in both groups were detected by ELISA. The difference of serum NFE2L2 level between necrotic group and normal group was compared. The levels of serum NFE2L2 in necrotic group were compared in stratified manner according to different factors. The correlation between serum NFE2L2 level and other clinical data was analyzed, and the significance of serum NFE2L2 diagnosis of NONFH was evaluated by drawing ROC diagnostic curve. [Results] Serum NFE2L2 level in necrotic group was significantly higher than that in normal group [(289.2±130.7) pg/ml vs (173.7±75.7) pg/ml, P＜0.001]. Although there was no significant difference in the level of serum NFE2L2 between different causes and different sides in the necrotic group (P＞0.05), the serum NFE2L2 level after femoral head collapse was significantly higher than that before femoral head collapse [(320.0±131.2) pg/ml vs (199.8±79.4) pg/ml, P=0.004]. In addition, the serum NFE2L2 level increased significantly with the progression of ARCO stages, with statistically significant differences among the different stages (P＜0.05). In term of correlation analysis, the serum NFE2L2 level was significantly positively correlated with ARCO stage and VAS score (P＜0.05), whereas significantly negatively correlated with Harris score (P＜0.05). In term of ROC analysis, the area under curve (AUC) of serum NFE2L2 level for the diagnosis of NONFH was of 0.769. [Conclusion] Serum NFE2L2 level is significantly elevated in patients with NONFH, which correlates with the severity of NONFH and may be a potential serum marker for the diagnosis of NONFH.