非创伤性股骨头坏死血清SFRP5的表达及临床意义△

Expression and clinical significance of serum SFRP5 in nontraumatic osteonecrosis of the femoral head

摘要:

[目的] 探讨分泌型卷曲相关蛋白-5 （secreted frizzled-related proteins-5, SFRP5） 在股骨头非创伤性坏死 （nontraumatic femoral head necrosis, NONFH） 中的意义。[方法] 选取 2023 年 9 月—2024 年 1 月在临沂市人民医院就诊的 NONFH 患者 71 例作为坏死组，选取同期性别、年龄与坏死组相匹配的 68 例健康体检者作为正常人组，采用酶联免疫吸附法检测两组受试者血清 SFRP5 浓度水平。比较两组间一般资料，坏死组按不同因素 （ARCO 分期、侧别、病因等） 比较血清 SFRP5 浓度水平，并绘制检测 ROC 曲线，分析血清 SFRP5 对 NONFH 的诊断价值。[结果] 坏死组血清 SFRP5 水平显著低于正常人组 [(16.9±12.7) pg/mL vs (32.9±17.2) pg/mL, P＜0.001]。坏死组中，股骨头塌陷患者血清 SFRP5 水平显著低于未塌陷患者 （P＜0.05）， 双侧坏死患者的血清 SFRP5 水平与单侧坏死患者的血清 SFRP5 水平差异无统计学意义 （P＞0.05），不同 ARCO 分期患者血清 SFRP5 水平的比较，随着分期的加重，血清 SFRP5 水平显著降低 （P＜0.05），差异有统计学意义 （P＜0.05）。两两相关分析方面，SFRP5 水平与 Harris 评分呈正相关 （P＜0.05），与 ARCO 分期、VAS 评分均呈显著负相关 （P＜0.05）。ROC 分析中，血清 SFRP5 水平在诊断股骨头坏死塌陷时的敏感性为 70.4%，特异性为 80.9%，曲线下面积（area under curve, AUC）为 0.787。[结论]随非创伤性股骨头坏死的进展，血清 SFRP5 水平呈下降趋势，SFRP5 可能是诊断 NONFH 潜在的血清标志物。 关键词：分泌型卷曲相关蛋白-5，非创伤性股骨头坏死，血清标志物

Abstract:

[Objective] To explore the role of secreted frizzled-related proteins 5 (SFRP5) in non-traumatic osteonecrosis of the femoral head (NONFH). [Methods] A total of 71 patients who were diagnosed of NONFH in Linyi People's Hospital from September 2023 to January 2024 were selected as the necrosis group, while other 68 healthy persons who underwent regular health physical examination and were matched in gender and age with the necrosis group were selected as the normal group. Serum SFRP5 levels in the two groups were detected by ELISA. General data between the two groups were compared, while the serum SFRP5 in the necrotic group were compared according to different factors (ARCO stage, side, etiology, etc.), and ROC curve was drawn to analyze the diagnostic value of serum SFRP5 for NONFH. [Results] The necrotic group had significantly lower serum SFRP5 than the healthy group [(16.9±12.7) pg/mL vs (32.9±17.2) pg/mL, P＜0.001]. In the necrosis group, the SFRP5 was significantly lower in the patients who had femoral head collapse than those without collapse (P＜0.05), whereas which was not statistically significant between the patients with bilateral necrosis and those with unilateral necrosis (P＞0.05). However, the SFRP5 was significantly decreased with the increasing of the ARCO stages (P＜0.05). In term of pairwise correlation analysis, SFRP5 was significantly positively correlated with Harris score (P＜0.05), while significantly negatively correlated with ARCO stage and VAS score (P＜0.05). In term of ROC analysis, the SFRP5 predicting NONFH was with sensitivity of 70.4% and specificity of 80.9% and area under curve (AUC) of 0.787. [Conclusion] Serum SFRP5 decreases with the progression of non-traumatic osteonecrosis of the femoral head, and SFRP5 may be a potential serum marker for the diagnosis of NONFH