非创伤性股骨头坏死患者血清Bax/Bcl-2意义

Significance of serum Bax/Bcl-2 in non-traumatic osteonecrosis of femoral head

[目的]探究非创伤性股骨头坏死(non-traumatic osteonecrosis of the femoral head, NONFH)血清Bax/Bcl-2检测的意义。[方法] 2021年3月—2021年7月,75例NONFH患者以及67例正常人纳入本研究。采用酶联免疫吸附法检测血清Bax、Bcl-2水平,计算Bax/Bcl-2值。患者按不同因素分组比较Bax/Bcl-2的差异性。血清检测结果同临床病例资料行相关性分析。Bax/Bcl-2检测结果与是否股骨头坏死行ROC曲线分析。[结果]坏死组患者血清Bax和Bax/Bcl-2显著高于正常人组(P<0.05)。激素、酒精和特发性股骨头坏死间Bax、Bax/Bcl-2水平差异无统计学意义(P>0.05);双侧坏死的病例Bax/Bcl-2显著高于单侧坏死病例(P<0.05);塌陷组Bax、Bax/Bcl-2显著高于未塌陷组(P<0.05)。随着ARCO分期等级越高,血清Bax、Bax/Bcl-2显著升高,差异有统计学意义(P<0.05)。相关分析表明:坏死组患者血清Bax和Bax/Bcl-2与ARCO分期呈显著正相关(P<0.05);血清Bax和Bax/Bcl-2水平与VAS评分呈正相关,与Harris评分呈负相关(P<0.05)。ROC曲线分析,Bax/Bcl-2用于诊断NONFH的曲线下面积(area under curve, AUC)值为0.844。[结论]血清Bax/Bcl-2水平与NONFH的病情严重程度相关,其水平变化或可作为临床判断NONFH的潜在指标。

[Objective] To explore the significance of serum Bax/Bcl-2 expression in non-traumatic osteonecrosis of the femoral head(NONFH). [Methods] A total of 75 patients with NONFH and 67 healthy subjects were included in the study from March 2021 to July 2021.The serum Bax/Bcl-2 were detected by enzyme linked immunosorbent assay(ELISA). The data were compared between the NONFH patients and normal subjects. In addition, the patients were divided into different groups according to different factors, and the Bax/Bcl-2 levels were compared among different groups. The correlation between the serum assays and clinical data was searched, and ROC curve analysis was performed on Bax/Bcl-2 and whether osteonecrosis of the femoral head happened. [Results] The NONFH patients had significantly higher serum Bax and Bax/Bcl-2 than the normal controls [(2.8±1.9) vs(1.4±0.7), P<0.05]. Of the NONFH patients, there was no significant difference in Bax/Bcl-2 among different etiological subgroups(P>0.05), however, the bilateral affected had significantly higher Bax/Bcl-2than the unilateral affected(P<0.05), the patients with femoral head collapsed had significantly higher Bax and Bax/Bcl-2 than those without femoral head collapsed(P<0.05). As ARCO classification progressed, the Bax and Bax/Bcl-2 upgraded significantly(P<0.05). In terms of correlations, the levels of Bax and Bax/Bcl-2 was positively correlated with ARCO stage and VAS score(P<0.05), whereas negatively correlated with Harris score(P<0.05). Furthermore, the ROC curve analysis showed that the area under the curve(AUC) of Bax/Bcl-2 for the predication of NONFH was of 0.844. [Conclusion] The level of serum Bax/Bcl-2 is related to the severity of NONFH, and may be used as a potential index for clinical judgment of NONFH.