血清Dickkopf-1蛋白在早期诊断股骨头坏死及病情监测中的意义

Significance of serum DKK1 protein in early diagnosis of osteonecrosis of femoral head and disease monitoring

目的通过检测股骨头坏死患者血清Dickkopf-1(DKK-1)蛋白含量变化,探究其在早期诊断股骨头坏死及病情监测中的意义。方法选取2016年5月—2016年11月于广州中医药大学第一附属医院住院的股骨头坏死患者67例(ARCO分期:Ⅱ期13例、Ⅲ期27例、Ⅳ期27例)作为实验组,并随机选取67例同期在该院体检中心体检正常者作为对照组,采用ELISA法检测两组患者的血清DKK-1蛋白浓度,比较并分析实验组与对照组、实验组内不同病因、不同ARCO分期患者的血清DKK-1蛋白浓度差异。结果实验组血清DKK-1蛋白浓度高于对照组(P <0.05);塌陷后患者血清DKK-1蛋白浓度高于塌陷前(P <0.05);不同病因的患者血清DKK-1蛋白浓度比较,差异无统计学意义(P>0.05);实验组ARCOⅡ、Ⅲ及Ⅳ期的患者血清DKK-1蛋白浓度比较,差异有统计学意义(P<0.05)。ROC曲线分析提示血清DKK-1蛋白在诊断股骨头坏死塌陷时具有一定的敏感性和显著的特异性,分别为57.40%和100.00%。血清DKK-1蛋白浓度与ARCO分期呈正相关(P<0.05)。结论血清DKK-1蛋白浓度与股骨头坏死患者的病情进展密切相关,对早期诊断股骨头坏死及监测患者病情变化具有一定的参考意义,可作为临床诊断及治疗的参考指标之一。

Objective To detect the serum Dickkopf 1(DKK1) protein level in patients with osteonecrosis of the femoral head, and explore its significance in early diagnosis and disease monitoring of osteonecrosis. Methods Sixty-seven patients with femoral head necrosis(ARCO stage: 13 cases in stage Ⅱ, 27 cases in stage Ⅲ, and 27 cases in stage Ⅳ) who were admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May to November 2016 were selected as the experimental group and 67 others who were normal from the Physical Examination Center of the same hospital in the same period were randomly selected as the control group. Enzyme-linked immunosorbent assay was used to detect the serum concentration of DKK1 protein in the two groups, and then the differences in serum DKK1 protein concentrations between the two groups and among the patients with different ARCO stages as well as different causes of femoral head necrosis in the control group were compared and analyzed. Results The serum DKK1 protein concentration in the experimental group was higher than that in the control group(P < 0.05). The serum DKK1 protein level before collapse was higher than that after collapse(P < 0.05). ROC curve indicated that serum DKK1 protein level had certain sensitivity(57.40%) and significant specificity(100%) in the diagnosis of femoral head necrosis collapse. There was no significant difference in serum DKK1 protein concentration between the patients with different causes(P > 0.05). The serum DKK1 protein concentration was significant different among the patients with different ARCO stages(P < 0.05), and serum DKK1 protein concentration had a positive correlation with ARCO stages(P < 0.05). Conclusions Serum DKK1 protein level is closely related to the progression of osteonecrosis of the femoral head. It has certain reference significance to early diagnosis of femoral head necrosis and monitoring the disease procession. It can be used as one of the reference indicators for clinical diagnosis and treatment of the disease.