Herring C型股骨头骨骺骨软骨病与凝血因素的相关性分析

Correlation analysis of Herring group C Legg-Calve-Perthes patients and coagulation factors

目的探讨HerringC型股骨头骨骺骨软骨病(以下简称Perthes病)患儿凝血相关指标变化与Perthes病的关系。方法回顾性分析2012年1月至2016年6月收治的4~8岁首次行单侧手术治疗的影像学表现为HerringC型患儿65例(研究组)的临床资料。研究指标包括:患儿首次出现疼痛、跛行等相关症状后就诊并确诊为HerringC型Perthes病的病情进展时间及凝血相关指标,并进行组内的相关性分析。同时,纳入相同年龄区间因多指畸形、马蹄足等与血栓形成倾向无明显影响的择期手术患儿30例为对照组,记录患儿相关凝血指标,与研究组进行对比研究。结果研究组患儿凝血酶原时间(PT)、PT国际标准化比值(PT.INR)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT)、D-二聚体(D-Dim)与病情进展时间并不存在显著相关性(|r|>0.7)。研究组患儿凝血相关指标分别为PT(11.45±0.77)s、PT.INR0.97±0.06、APTT(28.25±3.36)s、Fib(2.24±0.48)g/L、TT(18.09±1.35)s、D-Dim(0.34±0.72)mg/L,对照组分别为PT(11.43±0.77)s、PT.INR1.00±0.08、APTT(30.20±5.06)s、Fib(2.14±0.50)g/L、TT(18.32±1.21)s、D-Dim(0.21±0.16)mg/L,组间比较,差异无统计学意义(P均>0.05)。结论凝血因素可能并不是HerringC型Perthes病患儿的发病相关因素。

Objective To explore the relationship between the changes of coagulation parameters and Legg-Calve-Perthes disease (hereinafter referred to as Perthes disease) in children with Herring C Perthes disease. Methods Clinical data were retrospectively reviewed for 65 hospitalized patients with Herring C Perthes disease (research group) from January 2012 to June 2016. They underwent unilateral surgery for the first time. The relevant parameters included progression time between initial onset of pain, claudication and other related symptoms after a definite diagnosis of Herring C Perthes disease and the related coagulation parameters. The data were analyzed with regards to in-group correlation. At the same time, 30 children with elective surgery without obvious influence on thrombotic tendency such as olydactyly, clubfoot and so on were included as control group in the same age range. The relevant coagulation parameters were recorded and compared. Results In research group, there was no correlation between prothrombin time (PT), international normalized ratio of prothrombin time (PT.INR), activated partial thromboplastin time (APTT), fibrinogen (Fib), thrombin time (TT), d-dimer (D-Dim) or time of disease progression (|r|>0.7). The coagulation parameters in research group were PT (11.45±0.77) s, PT.INR 0.97±0.06, APTT(28.25±3.36)s, Fib(2.24±0.48)g/L, TT(18.09±1.35)s and D-Dim(0.34±0.72)mg/L. And control group were PT(11.43±0.77)s, PT.INR 1.00±0.08, APTT(30.20±5.06)s, Fib(2.14±0.50)g/L, TT(18.32±1.21)s and D-Dim(0.21±0.16)mg/L. There were no inter-group statistical differences (all P>0.05). Conclusions There is no correlation between disease progression and the coagulation parameters of Perthes disease. Moreover, no significant inter-group difference exists in coagulation parameters. Therefore the result of this research fails to support the assumption that coagulation abnormality is one of the pathogenetic factors for Legg-Calve-Perthes disease.