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血脂代谢在股骨头缺血性坏死病情分期中的应用价值

The Application Value of Lipid Metabolism in Staging of Avascular Necrosis of Femoral Head
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摘要 目的探究血脂代谢在股骨头缺血性坏死(avascular necrosis of the femoral head,ANFH)病情分期中的应用价值。方法回顾性选取2021年7月至2023年7月于首都医科大学附属北京积水潭医院就诊的ANFH患者361例,根据病情分期,分为轻中度组(n=202)、重度和极重度组(n=159);符合正态分布的计量资料采用t检验,非正态分布计量资料采用Mann-Whitney U检验;比较两组患者的临床资料;多因素Logistic回归分析ANFH严重程度的相关因素。绘制受试者工作特征(receiver operating characteristic,ROC),并计算曲线下面积(area under curve,AUC)以评估各指标诊断重度极重度ANFH的效能。结果比较两组患者的临床资料,结果显示,相较于轻中度组,重度和极重度组患者的高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(Apo-A1)水平均明显降低(P<0.05),低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、总胆固醇(CHOL)、三酰甘油(TG)、小而密低密度脂蛋白(sdLDL)、脂蛋白(a)[Lp(a)]水平均明显升高(P<0.05);回归分析结果显示,CHOL、HDL-C、LDL-C与ANFH患者病情分期密切相关;CHOL、LDL-C水平高,HDL-C水平低时患者病情为重度和极重度的风险更大,两组差异均有统计学意义(P<0.05);ROC曲线结果显示,CHOL、LDL-C、HDL-C 3者联合对诊断重度和极重度ANFH预测价值更高。结论CHOL、LDL-C、HDL-C与ANFH患者病情分期变化密切相关,CHOL、LDL-C、HDL-C 3者联合在诊断重度和极重度ANFH中具有较高预测价值,加强对ANFH患者CHOL、LDL-C、HDL-C的监测,可及早识别高危风险。 Objective To explore the application value of lipid metabolism in the stage of avascular necrosis of femoral head(ANFH).Methods From July,2021 to July,2023,361 patients with ANFH in Beijing Jishuitan Hospital affiliated to Capital Medical University were divided into mild to moderate group(n=202),severe group and extremely severe group(n=159).T test was used for dataset with normal distribution,while Mann-Whitney U test was used for dataset with non-normal distribution.The clinical data of the two groups were compared;Multivariate logistic regression was applied for the analysis of ANFH severity related factors.Receiver operating characteristic(ROC)and the area under the curve(AUC)were used to evaluate the effectiveness of various indicators in diagnosing severe and extremely severe ANFH.Results Comparisons of the clinical data of two groups of patients showed as follows:when compared to the mild to moderate group,levels of high-density lipoprotein cholesterol(HDL-C)and apolipoprotein A1(Apo A1)were significantly lower in both severe and extremely severe groups of patients(P<0.05);Levels of low-density lipoprotein cholesterol(LDL-C),apolipoprotein B(ApoB),total cholesterol(CHOL),triglycerides(TG),small and dense low-density lipoprotein(sdLDL),and lipoprotein(a)[Lp(a)]were significantly higher(P<0.05);The regression analysis showed that CHOL,HDL-C and LDL-C were closely related to the stage of ANFH.When CHOL and LDL-C levels were high,and HDL-C levels were low,patients had a greater risk of severe and extremely severe illness,and the difference between the two groups was statistically significant(P<0.05).ROC curve showed that the combination of CHOL,LDL-C and HDL-C had a higher predictive value in diagnosing severe and extremely severe ANFH.Conclusion CHOL,LDL-C,HDL-C are closely related to changes in the staging of ANFH patients.The combination of CHOL,LDL-C and HDL-C has a high predictive value in the diagnosis of severe and extremely severe ANFH.Strengthening the monitoring of CHOL,LDL-C and HDL-C in patients w
作者 胡洋 刘武征 李春艳 王旭 HU Yang;LIU Wuzheng;LI Chunyan;WANG Xu(Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)
出处 《标记免疫分析与临床》 CAS 2024年第8期1373-1377,1393,共6页 Labeled Immunoassays and Clinical Medicine
基金 国家自然科学基金青年科学基金项目(编号:82100257)。
关键词 股骨头缺血性坏死 总胆固醇 低密度脂蛋白胆固醇 高密度脂蛋白胆固醇 联合预测 回顾性研究 Avascular necrosis of the femoral head Total cholesterol Low density lipoprotein cholesterol High density lipoprotein cholesterol Combined prediction Retrospective study
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