超声联合分子生物学标志物检测诊断膝骨关节炎的价值

Value of ultrasound combined with molecular biological markers in the diagnosis of knee osteoarthritis

目的 :分析高迁移率族蛋白B1(HMGB1)及软骨寡聚基质蛋白(COMP)联合超声检查诊断膝骨关节炎(KOA)的价值。方法 :选取2016年1月至2017年12月收治的确诊KOA患者100例作为观察组,将同期健康体检者100人作为对照组。对所有受试者进行超声扫描,并检测患者血清中COMP和HMGB1水平,分析各指标单独诊断及联合诊断KOA的价值。结果 :观察组血中COMP及HMGB1水平分别为(379.85±24.39)ng/ml和(5.66±0.29)ng/ml,对照组分别为(214.28±32.43)ng/ml和(4.83±0.37)ng/ml,组间差异有统计学意义(P <0.05)。平行联合诊断灵敏度为97.00,显著高于各指标单独应用(P <0.05),系列联合诊断特异度为96.00,显著高于各指标单独应用(P <0.05),且平行联合及系列联合诊断的ROC曲线下面积(0.946),显著高于各指标单独应用(P <0.05)。结论 :超声联合血清COMP、HMGB1诊断KOA可有效提高诊断灵敏度和特异度,具有较高的临床应用价值。

Objective: To analyze the value of high mobility group protein B1(HMGB1) and cartilage oligomeric matrix protein(COMP) combined with ultrasound in the diagnosis of knee osteoarthritis(KOA). Methods: One hundred patients with confirmed KOA admitted from January 2016 to December 2017 were selected as an observation group, and 100 health examinees in the same period were taken as a control group. Ultrasound scans were performed on all subjects and serum levels of COMP and HMGB1 were measured to analyze the value of each indicator for individual diagnosis and combination diagnosis of KOA. Results: The levels of COMP and HMGB1 in the observation group were (379.85±24.39) ng/ml and (5.66±0.29) ng/ ml, respectively, those in the control group were (214.28±32.43) ng/ml and (4.83±0.37) ng/ml, respectively, and the difference between the two groups was statistically significant(P<0.05). The sensitivity of parallel combination diagnosis was 97.00, which was significantly higher than that of single application of each index(P<0.05). The combination diagnosis specificity of the series was 96.00, which was significantly higher than the single application of each index(P<0.05). The area under the ROC curve(0.946) of the parallel combination and serial combination diagnosis was significantly higher than that of single application of each index(P<0.05). Conclusion: Ultrasound combined with serum COMP and HMGB1 can effectively improve the sensitivity and specificity of KOA diagnosis, and has high clinical application value.