摘要
目的测定非创伤性股骨头坏死(nontraumaticosteonecrosisoffemoralhead,NONFH)患者的血液学指标变化,筛选敏感分子标记物用于早期诊断和筛选高危人群。方法研究对象共分三组:(1)NONFH早期组(塌陷前期)30例,(2)NONFH晚期组(塌陷后期)30例,(3)正常对照组30例。各组对象均抽取空腹肘静脉血。应用酶联免疫吸附法(ELISA)测定血小板α-颗粒膜蛋白(GMP-140)、血浆蛋白C(PC)、D-二聚体(D-Dimer)含量;发色底物法测定血浆纤溶酶原激活剂抑制剂(PAI)活性。结果(1)NONFH早、晚期组血小板GMP-140含量均高于正常对照组,血浆PC含量均低于正常对照组,D-Dimer含量均高于正常对照组,PAI活性均高于正常对照组(P均<0.05)。骨坏死情况越严重,各项指标上升或降低的趋势越明显,而且各项指标早、晚期组间比较差异均有显著性(P均<0.05)。(2)经判别分析,筛选出PAI、D-Dimer、PC三个指标,建立NONFH早期、晚期和正常对照三类判别函数式。NONFH早期:Y1=?26.3966+41.4916X10+0.0512X4+4.1390X1;NONFH晚期:Y2=?66.7566+82.1315X10+0.1082X4+2.7233X1;正常对照组:Y3=?26.7049+20.5695X10+0.0327X4+6.1900X1。回代判对率97.78%。结论(1)NONFH患者各期均存在高凝和低纤溶状态。(2)PAI、D-Dimer、PC为NONFH患者的血液学敏感指标。
Objective To study the hematological changes o f nontraumatic osteonecrosis of the femoral head,select the sensitive molecular symbols for early diagnosis and distinguish the high risk peopl e.Methods The studied subjects were divided in to three groups:1)NONFH early stage group(n=30);2)NONFH late stage group(n=30);3)the normal controlled group(n=30).Blood samples from cubital veins were collected.GMP -140,PC,D -Dime r were examined using ELISA.PAI was e xamined with chromogenic assay.Results1)The platelet GMP -140levels of early or late stage groups NONFH were signi ficantly higher than that of the normal contro lled group;the plasma PC levels of both groups were lower than that of the normal controlled group significan tly(P<0.05);the plasma D -Dimer concentrations of both groups were higher than that of the normal contro lled group significantly;the plasm a PAI activity of both groups increased significantly as compared with the n ormal controlled group(P<0.05).The worse the osteonecrosis,the higher or lower the index.And for all indices,there was significant difference between NONFH early stage and late stage group(P<0.05).2)Three types discriminant functions of NONFH early stage,late stage and normal control were set up by PAI,D -Dimer,PC which were discriminated.NONFH in early stage:Y 1 =-26.3966+41.4916X 10 +0.0512X 4 +4.1390X 1 ;NONFH in late stage:Y 2 =-66.7566+82.1315X 10 +0.1082X 4 +2.7233X 1 ;the group in normal control:Y 3 +6.1900X 1 .The functionsefficiency is 97.78%.Conclusion1)Hypercoagulability and hypofibrin olysis were found in all stages of patients with NONFH;2)PAI,D -Dimer and PC were sensitive mo lecular symbols of blood changes in early stage in patie nts with NONFH.[
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第7期423-426,共4页
Chinese Journal of Orthopaedics
