缺血性股骨头坏死患者与正常受试者血浆糖盏蛋白水平的比较其临床意义

Study of the difference of plasma glycocalicin levels between patients with avascular necrosis of the femoral head and healthy people and its clinic significance

目的探讨缺血性股骨头坏死患者血浆糖盏蛋白水平的改变及其临床意义。方法检测在华中科技大学同济医学院附属协和医院骨伤科病房与门诊就诊的52例缺血性股骨头坏死患者和48名健康志愿者的血浆糖盏蛋白水平、血小板聚集率和纤维蛋白原含量,对每位受试者均做Harris评分。结果缺血性股骨头坏死患者血浆糖盏蛋白水平较正常人升高,血小板聚集率较正常人降低。血浆糖盏蛋白水平与股骨头坏死危险因素不相关,与Harris评分及纤维蛋白原呈正相关。血小板聚集率4 min和10 min时与纤维蛋白原正相关,2 min时与纤维蛋白原不相关。结论高含量纤维蛋白原促进糖盏蛋白的产生,其通过竞争性抑制血小板聚集缓解临床症状。血浆糖盏蛋白升高可能是缺血性股骨头坏死的一种自我保护机制。

Objective To study the difference of plasma glycocalicin levels between patients with avascular necrosis of the femoral head （ANFH） and healthy people and its significance. Methods 52 patients with ANFH and 48 healthy adult were enrolled. Plosma levels of glycocalicin （GC） were detected by enzyme-labeled immunosorbent assay （EL1SA）. Platelet aggregation ratio （PAA） was measured by platelet aggregometer. Fibrinogen （FIB） was detected by blood flow rheometer. Harris Hip Score （HHS） was performed as functional scores. Results Levels of the GC increased and levels of PAA were decreased significantly in ANFH group. No correlation was founded between the plasma level of GC and the risk factors for ANFH. The blood plasma levels of GC had a positive correlation with HHS and FIB. The FIB was positively correlated with PAA at 4 minutes and 10 minutes but not at 2 minutes. Conclusion High concentration of FIB induced GC production, thus the PAA reduced, the clinical symptoms relieved. The elevated blood plasma GC was a self-protection mechanism in ANFH patients.