摘要
目的探究透明质酸、血清红细胞沉降率(ESR)及X线影像中骨密度指标与髋膝关节炎发病之间的关联。方法本研究回顾性纳入2023年12月至2024年12月滨州医学院附属烟台山医院关节外科116例患者,其中76例确诊患者为观察组(男39例,40~70岁;女37例,40~70岁),40例排除关节病变者为对照组(男22例,40~68岁;女18例,40~69岁)。收集透明质酸、血清ESR、骨密度等资料,运用独立样本t检验分析组间差异,通过多因素Logistic回归筛选发病影响因素,并利用接受者操作特性曲线(ROC)曲线及曲线下面积(AUC)评估各指标及联合检测的预测效能。结果本研究观察组关节外伤史、家族关节炎病史、透明质酸、血清ESR高于对照组[64.50%比22.50%,χ^(2)=18.468,P<0.01;59.20%比15.00%,χ^(2)=20.792,P<0.01;(122.32±21.82)μg/L比(93.70±25.09)μg/L,t=-6.372,P<0.01;(30.59±13.78)mm/h比(14.80±13.47)mm/h,t=-5.913,P<0.01],观察组骨密度低于对照组[(0.91±0.09)g/cm 3比(1.01±0.08)g/cm 3,t=-5.578,P<0.01];多因素Logistic回归分析关节外伤史[比值比(OR):6.251,95%可信区间(CI):2.597~15.045]、家族关节炎病史(OR:8.226,95%CI:3.084~21.941)、透明质酸(OR:1.052,95%CI:1.032~1.072)、血清ESR(OR:1.081,95%CI:1.047~1.117)为发病危险因素,骨密度为保护因素(OR:0.579,95%CI:0.215~0.786)差异有统计学意义(P<0.05);对比曲线下面积(AUC),透明质酸、血清ESR、骨密度AUC分别为0.796(95%CI:0.712~0.865)、0.787(95%CI:0.701~0.857)、0.785(95%CI:0.699~0.855),联合检测(AUC=0.917)较透明质酸、血清ESR、骨密度单一检测对髋膝关节炎发病具有更高的预测价值(P<0.05)。结论关节外伤史、家族病史、透明质酸、血清ESR和骨密度均为髋膝关节炎发病的影响因素,透明质酸、血清ESR、骨密度联合检测对髋膝关节炎发病预测价值良好。
Objective To investigate the relationship between hyaluronic acid,serum erythrocyte sedimentation rate(ESR),and bone mineral density(BMD)in X-ray images and the incidence of hip and knee arthritis.Methods This retrospective study included 116 patients admitted to the Department of Joint Surgery at the Affiliated Yantaishan Hospital of Binzhou Medical University between December 2023 and December 2024.Among them,76 patients were diagnosed as the observation group(39 males,40-70 years old;37 female,40-70 years old),and 40 patients without joint disease were enrolled as the control group(22 males,40-68 years old;18 female,40-69 years old).Independent sample t test was used to analyze the differences between groups.Multivariate Logistic regression was used to screen the risk factors.Receiver operating characteristic curve(ROC)curve and AUC were used to evaluate the predictive efficacy of each index and combined detection.Results In this study,among the observation group diagnosed with hip and knee arthritis,there were 30 cases of hip arthritis and 46 cases of knee arthritis.The history of joint trauma in the observation group(64.50 vs.22.50%,χ^(2)=18.468,P<0.01)and the family history of arthritis(59.20 vs.15.00%,χ^(2)=20.792,P<0.01),hyaluronic acid[(122.32±21.82)μg/L vs.(93.70±25.09)μg/L,t=-6.372,P<0.01],and serum ESR[(30.59±13.78)mm/h vs.(14.80±13.47)mm/h,t=-5.913,P<0.01]were significantly higher than those in the control group.Bone mineral density[(0.91±0.09)g/cm 3 vs.(1.01±0.08)g/cm 3,t=-5.578,P<0.01]was lower than that of the control group;Multivariate Logistic regression analysis showed that history of joint trauma[odds ratio(OR):6.251,95%confidence interval(CI):2.597-15.045],family history of arthritis(OR:8.226,95%CI:3.084-21.941),hyaluronic acid(OR:1.052,95%CI:1.032-1.072),ESR(OR:1.081,95%CI:1.047-1.117)were risk factors,and BMD(OR:0.579,95%CI:0.215-0.786)was a protective factor(P<0.05).the area under the curve(AUC)was 0.796(95%CI:0.712-0.865)for HA,0.787(95%CI:0.701-0.857)for ESR,and 0.785(95%CI:0.699-0.855)for BMD,and the combined detection(AUC=0.917)had a higher predictive value than the single detection of hyaluronic acid,serum ESR,and bone mineral density(P<0.05).Conclusion A history of joint trauma,family history,hyaluronic acid,serum ESR,and bone mineral density are all influencing factors in the development of hip and knee osteoarthritis.Combined detection of hyaluronic acid,serum ESR,and bone mineral density has good predictive value for the development of hip and knee osteoarthritis.
作者
潘静波
罗义岩
张成成
王文魁
孙秀江
张健
刘丹
Pan Jingbo;Luo Yiyan;Zhang Chengcheng;Wang Wenkui;Sun Xiujiang;Zhang Jian;Liu Dan(Department of Orthopedics,Yantaishan Hospital Affiliated to Binzhou Medical University,Yantai 264003,China;Department of Orthopedics,Penglai People’s Hospital,Yantai 265600,China;Institute of Orthopaedics,Fourth Medical Center,General Hospital of the Chinese People’s Liberation Army,Beijing 100853,China)
出处
《中华实验外科杂志》
2025年第11期2365-2368,共4页
Chinese Journal of Experimental Surgery
关键词
透明质酸
血清红细胞沉降率
骨密度
髋膝关节炎
关节炎病史
Hyaluronic acid
Serum erythrocyte sedimentation rate
Bone mineral density
Arthritis of the hip and knee
History of arthritis
