| Objective: avascular necrosis of the femoral head(ANFH) is a frequently occurring bone, common diseases, mainly in the young adults, is a bone disease of serious threat to human health. ANFH begin insidious, its pathological process is complex, its exact etiology and pathogenesis has not yet fully clear, so domestic and foreign scholars are highly concerned about it. For a long time, the close relationship between disorders of lipid metabolism and avascular necrosis of the femoral head have been found by many scholars. Therefore, On the basis of the predecessors experimental research of animal's models and clinical trials, we monitor and research the lipid levels of patients with ANFH, to evaluate the exact cause and pathogenesis of ANFH, to verify the relation between disorders of lipid metabolism and ANFH,and to provide theoretical and experimental basis of the early clinical diagnosis and prevention of ANFH.Methods: Select 89 patients with avascular necrosis of femoral head and 89 the same time patients with non-avascular necrosis of femoral head in the Third Hospital of Hebei Medical University(2009.3-2009.12), they been divided into the ANFH groups (patients been diagnosed as ANFH by CT or MRI or Pathology, age:23 years to 62 years, average age:44.6 years, male 71, female 18) and the control group (patients been diagnosed as non-ANFH by CT or MRI or Pathology and been eliminate the use of lipid-lowering drugs in the near future, age:25 years to 58 years, average age:41.4 years, male 64, female 25). To collect 4ml Fasting venous blood, instrument:the Hitachi 7000 automatic biochemical analyzer. Blood-lipid data Statistical analysis was performed using SPSS 13.0 statistical software.Measurement data were presented as mean±standard deviation( x±s). Settingα= 0.05,there was statistical significance if P<0.05 for the difference, and significant statistical significance if P<0.01 for the difference.Results: TC,TG,LDL,Apo-B disturb in the avascular necrosis of femoral head group were (4.99±1.06mmol/L, 1.62±0.77mmol/L, 3.10±1.01mmol/L, 0.99±0.28g/L)respectively, which increased remarkably compared with the control group (3.38±1.10mmol/L, 1.06±0.40mmol/L, 2.50±0.45mmol/L, 0.85±0.18g/L), there are statistically significant difference (p<0.01 and p<0.05); while HDL,Apo-AI levels in the avascular necrosis of femoral head group were (0.88±0.18mmol/L, 1.20±0.17g/L), which lower remarkably compared with the control group (1.36±0.32mmol/L, 1.55±0.31g/L), there are statistically significant difference (p<0.01).Conclusion: 1 There are disorders of lipid metabolism in the patients with the avascular necrosis of femoral head. 2 Hyperlipemia led to abnormal blood viscosity, blood flow down; In addition, hyperlipemia damage vascular endothelial cell, resulting in the occurrence of atherosclerosis and blood coagulation solvent system disorders, patients are at high risk of thrombosis. At the same time, disorders of lipid metabolism, lipid droplets come into the blood, fat embolism evolve continuously, these worsen the region of the femoral head blood-supply microcirculation, until the occurrence of bone necrosis. 3 The disorders of lipid metabolism can differentiate a large number of bone marrow stromal cells into fat cells, accumulation of adipose tissue would stuff inevitably bone marrow,then lead to abnormally elevated iop (intraosseous pressure), which decreases blood perfusion,so that the blood supply of femoral head significantly reduced.The last,bone cells die. 4 The disorders of lipid metabolism, fat or its components were uptaked bone cells, causing lipid deposition of the bone cells and fused into lipid droplets, resulting in Compression of karyon and side-together of karyon, this is so-called the phenomenon of "peripheral", thereby bone cells shrinkage, pyrolysis and die. Meanwhile, the reduction of osteoblast differentiation, which slow down the bone repair and plastic, eventually leading to collapse, increasing femoral head necrosis. 5 There are disorders of lipid metabolism in the patients with the avascular necrosis of femoral, abnormal lipid metabolism leading to occurrence of osteonecrosis of femoral head through the above-mentioned a variety of mechanisms, to monitor the lipid levels of patients with ANFH, and to disturb abnormal blood-lipid levels, there is an important guiding significance to the treatment and the assessment of long-term efficacy with ANFH. 6 The inhibition of lipid etabolism and the concomitant enhancement of osteogenesis may provide a novel approach to the prevention or treatment of the avascular necrosis of femoral head.
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