Objective To observe the changes of serum levels of cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase 13 (MMP13) in patients with ischemic necrosis of femoral head (INFH), and to explore their clinical significances. Methods A total of 38 patients with INFH after femoral neck fracture surgery in Puning People's Hospital from January 2012 to January 2015 were randomly selected as observation group. At the same time, 30 patients without INFH after femoral neck fracture surgery were selected as operation control group and 30 healthy persons were collected as healthy control group. Patients in observation group were performed core decompression, and serum COMP and MMP13 levels at 1, 3, 5, 7, 10 d postoperatively were examined by ELISA method; Meanwhile, serum levels of COMP and MMP13 in other 2 groups were also detected. In observation group, relationships between serum COMP, MMP13 levels and postoperative Harris scores were analyzed, and ROC curve analysis was applied to evaluate the predicting value of combined examination of serum COMP and MMP13 levels for hip joint function recovery in INFH patients. Results Serum COMP and MMP13 levels in observation group before treatment were (13.5 ± 2.4) U/L and (45.5 ± 2.2) μg/L respectively, which were higher than (8.5 ± 1.5) U/L, (34.4 ± 1.9)μg/L in operation control group and (5.2 ± 1.1) U/L, (27.2 ± 1.4) μg/L in healthy control group;The above parameters in operation control group were all higher than those in healthy control group (P <0.05). Compared with preoperative results, serum COMP and MMP13 level at 5, 7 and 10 days postoperatively were lower (P<0.05) in observation group; Harris score at 1, 3 months postoperatively was 87 ± 7 and 94 ± 3 respectively, and hip joint function were excellent in 12 patients, good in 17, fair in 6 and poor in 3 at 3 months after the surgery, with the excellent and good rate of 76% (29/38). Serum COMP and MMP13 levels in patients with excellent and good hip joint function recovery were lower than those in patients with fair or poor function recovery (P <0.05). ROC analysis results showed that when serum COMP and MMP13 level cutoff value was 13.14 U/L + 44.85 μg/L, the sensitivity, specificity, positive predictive value and negative predictive value was 97%, 89%, 97% and 89% respectively, which had highest prognostic value. Conclusions Serum COMP and MMP13 levels in INFH patients are relative high which were closely related to their hip functions, and the combined examination has good value in predicting the early recovery of hip joint functions.%目的：观察股骨头缺血性坏死（INFH）患者血清软骨寡聚基质蛋白（COMP）和基质金属蛋白酶13（MMP13）水平变化并探讨其临床意义。方法将2012年1月至2015年1月普宁市人民医院收治的38例股骨颈骨折术后发生INFH的患者作为观察组，另选取30例同期股骨颈骨折术后无INFH患者作为手术对照组，30例同期健康查体者作为健康对照组。观察组采用髓芯减压术治疗，运用ELISA法检测术前，术后1、3、5、7、10 d血清COMP和MMP13水平，同时记录两对照组血清COMP和MMP13水平。根据Harris评分评价观察组患者术后髋关节功能；分析血清COMP和MMP13水平与术后Harris评分的关系，采用ROC分析血清COMP和MMP13水平对INFH患者髋关节功能恢复情况的预测价值。结果观察组术前血清COMP、MMP13水平分别为（13.5±2.4）U/L、（45.5±2.2）μg/L，高于手术对照组和健康对照组的（8.5±1.5）U/L和（5.2±1.1）U/L、（34.4±1.9）μg/L和（27.2±1.4）μg/L；手术对照组上述指标亦高于健康对照组（P＜0.05）。观察组术后5、7、10 d血清COMP和MMP13水平均较术前明显降低（P＜0.05）；术后1、3个月Harris评分分别为（87±7）分和（94±3）分，术后3个月髋关节功能优、良、中、差分别为12、17、6、3例，优良率为76%（29/38）；髋关节功能恢复优良者血清COMP和MMP13水平均低于中差者（P＜0.05），血清COMP和MMP13水平截断值为13.14 U/L+44.85μg/L时，敏感度、特异度、阳性预测值和阴性预测值分别为97%、89%、97%、89%，预测价值最高。结论INFH患者血清COMP和MMP13水平较高，且与髋关节功能密切相关，联合检测对患者术后髋关节功能的早期预测价值良好。
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