廖林波+梁俊卿+农峰+吴昭元+唐毓金+谢克恭+卢贤哲+蓝常贡

【摘要】目的检测缺血性股骨头坏死患者骨形态形成拮抗蛋白1（GREM1）的表达水平，以研究其临床意义。

方法选择2016年4～10月收治的58例缺血性股骨头坏死患者作为观察组，同期选择在体检中心进行健康体检的76名健康者作为观察组，应用酶联免疫吸附法（ELISA）检测两组血清GREM1的表达含量，同时应用常规方法对C反应蛋白（CRP）进行检测，比较两组间GREM1、CRP水平的表达差异，分析观察组GREM1水平与CRP水平之间的相关性。

结果观察组血清GREM1、CRP的表达水平均较对照组显著增高（P<0.01）；在观察组中，临床Ficat Ⅲ/Ⅳ期患者血清GREM1的水平较Ficat Ⅰ/Ⅱ期患者升高（P<0.001）；经Pearson线性相关性分析发现，观察组患者血清GREM1水平与CRP水平之间的相关性不显著（r=-0.118，P>0.05）。

结论缺血性股骨头坏死患者血清GREM1的水平显著升高，提示其可能参与缺血性股骨头坏死的发生与发展。

【关键词】股骨头坏死；骨形态形成拮抗蛋白1；C反应蛋白

中图分类号：R681.8文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.005

【Abstract】ObjectiveTo detect the expression level of serum GREM1 in patients with ischemic necrosis of femoral head （INFH），so as to explore its clinical significance.

Methods58 cases of INFH admitted to hospital from April，2016 to October，2016 were selected as observation group，and 76 healthy subjects who underwent physical examination in physical examination center in the same period were chosen as control group.And then，the serum levels of GREM1 of the two groups were measured by enzyme linked immunosorbent assay（ELISA），and C reactive protein（CRP） was detected by routine method.In addition，difference of the expressions of GREM1 and CRP levels between the two groups was compared，and the linear correlation between them in the observation group was analyzed.

ResultsThe levels of GREM1 and CRP in the observation group improved more significantly than those of the control group（P<0.01）.In the observation group，the level of serum GREM1 in patients with stage Ficat Ⅲ/Ⅳ was higher than that in patients with stage Ficat Ⅰ/Ⅱ（P<0.001）.Pearson linear correlation analysis showed that there was no significant correlation between serum GREM1 level and CRP level in the observation group（r=-0.118，P>0.05）.

ConclusionThe level of serum GREM1 in patients with INFH increases，which suggests that it may involve in the occurrence and development of INFH.

【Key words】INFH；GREM1；CRP

缺血性股骨头坏死（Ischemic necrosis of the femoral head，INFH）是一种以单侧或双侧髋关节疼痛伴活动受限为主要临床表现的常见性骨科疾病。由于其给患者带来极大的痛苦，严重影响患者的生活质量，现已成为严重威胁公共健康的骨关节疾病[1]。然而目前INFH的确切发病机制尚未阐明。骨形态形成拮抗蛋白1（GREM1）是一个由184个氨基酸残基构成的分子量为27 kD的分泌型糖蛋白，属于骨形态形成蛋白（BMP）拮抗剂家族的重要成员之一[2]。GREM1分子在细胞和组织的分化及生长过程中起着重要的作用，参与多种疾病的发生[3]。……