血清瘦素水平在预测非创伤性股骨头坏死塌陷中的效果研究

摘要

目的 探索血清瘦素水平在预测非创伤性股骨头坏死塌陷中的效果.方法 研究选取确诊的非创伤性股骨头坏死患者112例进行研究,其中非创伤性股骨头坏死同时并发塌陷患者53例,为病例组;单纯非创伤性股骨头坏死患者59例,为对照组.分析血清瘦素水平对非创伤性股骨头坏死塌陷的关联.研究中的数据均应用SPSS 20.0统计软件进行分析.结果 本研究中两组患者基本情况差别未见统计学意义,可比性良好.病例组患者平均的血清瘦素为25.06 ±4.08μg/L,高于对照组的16.77±3.88μg/L,差别有统计学意义(P＜0.05);同时分析比较了病例组和对照组患者的血脂水平:病例组的甘油三酯水平为1.95 ±0.32mmol/L,对照组为1.39 ±0.40mmol/L,差别有统计学意义(P＜0.05);此外,病例组的高密度脂蛋白水平低于对照组,低密度脂蛋白水平高于对照组,且均P ＜0.05.但是病例组的总胆固醇水平4.74±0.95mmol/L,对照组为4.23±1.14mmol/L,差别不具有统计学意义.对血清瘦素以及与非创伤性股骨头坏死塌陷存在潜在关联的因素进行Logistic回归分析.单因素Logistic回归分析结果提示,血清瘦素水平异常增高是非创伤性股骨头坏死塌陷发生的危险因素,OR值为1.178(1.065 ～1.302),P＜0.05;经潜在昆杂因素性别、年龄以及BMI和血脂水平调整后,血清瘦素水平异常增高仍然表现为一个危险因素.进一步进行多因素Logistic回归分析,提示血清瘦素水平异常增高OR值为1.160(1.047～1.285),P＜0.05;同时高密度脂蛋白水平异常减低和年龄增高也均为危险因素,OR值分别为1.002(1.001 ～1.004)和1.038(1.027 ～ 1.150);而男性则表现为一个保护因素,OR值为0.980(0.976～0.984).结论 非创伤性股骨头坏死塌陷患者平均的血清瘦素水平高于单纯非创伤性股骨头坏死患者,且倾向于高血脂状态;血清瘦素水平异常增高对于预测非创伤性股骨头坏死塌陷具有一定临床价值,但同时受到血脂、性别以及年龄因素的影响.%Objective To explore the effect of serum leptin level on predicting the necrosis of non-traumatic femoral head.Methods 112 patients with non-traumatic necrosis of the femoral head were enrolled in this study.Among these 112 patients,53 patients were dignosed with collapse in femoral head and selcted as observation group,and the other 59 cases without collapse were selcted as control group.The relationship between serum leptin level and non-traumatic necrosis of the femoral head with collapse were investigated.The data in the study were analyzed by SPSS 20.0 statistical software.Results The difference between the two groups was not statistically significant and the comparability was good.The mean value of serum leptin level in observation group was25.06 ±4.08μg/L and significantly higher than that in the control group(16.77 ±3.88μg/L),P ＜0.05.Blood lipids in observation group was 1.95 ±0.32mmol/L in the control group and significantly higher than that in the control group (1.39 ± 0.40mmol/L),P ＜ 0.05.In addition,The level of high density lipoprotein in the observation group was lower than that in the control group,and the level of low density lipoprotein in the observation group was higher than that of the control group (both P ＜ 0.05).However,the total cholesterol levels in the observation group and the control group were 4.74 ± 0.95mmol/L and 4.23 ± 1.14mmol / L,and there was no statstically significant difference.Logistic regression analysis was performed on the potential association of serum leptin and non-traumatic necrosis of the femoral head.Univariate logistic regression analysis showed that the abnormal level of serum leptin was the risk factor of non-traumatic necrosis of femoral head,and the OR value was 1.178 (1.065-1.302),P ＜ 0.05;after modifying sex,age and BMI and serum lipid level,abnormally increasing serum leptin levels still showed a risk factor.Further analysis of multivariate logistic regression showed that the serum leptin level abnormally increased by 1.160(1.047-1.285),P ＜ 0.05,and the abnormality of high density lipoprotein and age were also risk factors.OR values were 1.002(1.001-1.004) and 1.038(1.027-1.150);while men showed a protective factor,OR was 0.980 (0.976-0.984).Conclusion The average serum leptin level in patients with non-traumatic necrosis of the femoral head is higher than that in the patients with traumatic necrosis of the femoral head,and it is prone to hyperlipidemia.Abnormal serum leptin level has a certain clinical value on the prediction of non-traumatic necrosis of the femoral head,but at the same time is affected by the blood lipids,sex and age factors.