血清sICAM-1与酒精性股骨头坏死的相关性研究

Correlation of Serum Soluble ICAM-1 and Alcohol-induced Osteonecrosis of Femoral Head

目的探讨血清可溶性细胞间黏附分子-1(sICAM-1)与酒精性股骨头坏死(AIONFH)的相关性。方法选取2021年7月—2022年3月收治的AIONFH 64例作为AIONFH组,同期健康体检者63例作为健康对照组。比较2组一般资料和血清sICAM-1水平,AIONFH患者不同指标分组疼痛视觉模拟评分法(VAS)、Harris评分和血清sICAM-1水平,采用Spearman相关性分析探讨AIONFH患者血清sICAM-1水平与临床指标的相关性,绘制受试者工作特征(ROC)曲线评估血清sICAM-1诊断AIONFH的价值。结果AIONFH组血清sICAM-1水平高于健康对照组(P<0.01)。64例AIONFH中血清sICAM-1水平双侧发病者高于单侧发病者;VAS评分和血清sICAM-1水平股骨头已塌陷者高于未塌陷者,国际骨循环研究协会(ARCO)分期Ⅱ期者低于Ⅲ和Ⅳ期者,Ⅲ期者低于Ⅳ期者;Harris评分股骨头已塌陷者低于未塌陷者,ARCO分期Ⅱ期者高于Ⅲ和Ⅳ期者,Ⅲ期者高于Ⅳ期者(P<0.01)。Spearman相关性分析结果显示,AIONFH患者血清sICAM-1水平与VAS评分、股骨头塌陷程度和ARCO分期均呈正相关,与Harris评分呈负相关(P<0.01)。ROC曲线分析结果显示,血清sICAM-1诊断AIONFH的最佳截断值为240.99 ng/ml,此时敏感度为78.10%,特异度为71.40%,曲线下面积为0.818(95%CI 0.746,0.891)。结论血清sICAM-1水平升高可反映AIONFH病情严重程度,是诊断AIONFH的潜在标志物。

Objective To evaluate the correlation of serum soluble intercellular adhesion molecule-1(sICAM-1)and alcohol-induced osteonecrosis of femoral head(AIONFH).Methods The clinical data of 64 AIONFH patients who were admitted to our hospital from July 2021 to March 2022 were collected,and 63 healthy subjects who underwent physical examination during the same period were used as controls.General data and serum SICAM-1 levels in the two groups were compared in the two groups.The visual analogue scale(VAS)pain score,Harris score and serum sICAM-1 level of patients with AIONFH that were grouped by different indicators were compared.Spearman correlation analysis was used to explore the correlation between serum sICAM-1 level and clinical indicators of patients with AIONFH,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of serum sICAM-1 in the diagnosis of AIONFH.Results The serum sICAM-1 level in AIONFH patients was higher than that in healthy subjects(P<0.01).The serum sICAM-1 level in 64 AIONFH patients with bilateral involvement of femoral head was significantly higher than that in patients with unilateral involvement;the VAS score and serum SICAM-1 level were higher in patients with femoral head collapse(FHC)than in those without FHC,lower in association research circulation osseous(ARCO)stageⅡthan in stageⅢand stageⅣ,and lower in stageⅢthan in stageⅣ.Harris score was lower in patients with FHC than in patients without FHC,higher in ARCO stageⅡthan in stageⅢandⅣ,and higher in stageⅢthan in stageⅣ(P<0.01).Spearman correlation analysis showed that serum sICAM-1 level of patients with AIONFH was positively correlated with VAS score,severity of FHC and ARCO stage,and negatively correlated with Harris score(P<0.01).ROC curve analysis showed that when the optimal cut-off value of serum sICAM-1 level in diagnosing AIONFH was 240.99 ng/ml,the sensitivity was 78.10%,the specificity was 71.40%,and the area under the ROC curve was 0.818(95%CI 0.746,0.891).Conclusion The increased serum sICAM-1 level can reflect the severity of AIONFH and is a potential marker for the diagnosis of AIONFH.