| As a common and frequently occurring disease worldwide,avascular necrosis of the femoral head?ANFH?,a hip-prone site,often leads to pain and dysfunction of the hip joint and even depression and anxiety Problems;these diseases seriously reduce the patient's quality of life,and because of the cost of surgery for hip replacement surgery is generally higher than the average surgery,will undoubtedly increase the patient's financial burden[1].Currently in clinical treatment of avascular necrosis of the femoral head,there is no really effective and radical cure,for early and mid-term patients with avascular necrosis,the main treatment is to reduce pain and improve patient joint function Mainly in patients with advanced,often require hip replacement surgery to completely solve the hip problem.There are many methods for the classification of avascular necrosis of the femoral head.Ficat staging is one of the most commonly used methods in clinical practice.This staging system is the earliest systematic staging system for ANFH.Currently,the staging system is widely used in clinical practice[2-5].According to incomplete statistics,there are about 600 to 850 million patients with osteonecrosis of the femoral head in China,and about 10 to 20 million new cases occur each year[1].The disease is more common in young men aged 35 to 55 years of age;once the onset,if not treated,about 70%femoral head of patients will collapse,usually 3-4 years after the need for total hip arthroplasty[6].Clinically,the diagnosis of patients with avascular necrosis of the femoral head is also mainly through imaging data and clinical symptoms,and different imaging methods to determine the criterion of avascular necrosis is not exactly the same.According to the clinical observation of the study we found that the X-ray of the hip,MRI findings often differ from the results seen during the operation.Although most patients with avascular necrosis can eventually be treated with hip arthroplasty,the costly surgical and surgical age limitations on the patient's age have led us to look for a better approach to hip replacement;Studies have shown that if the early diagnosis of avascular necrosis can be interrupted,intervention treatment to delay the progress of the disease,it can significantly reduce the number of patients who need hip replacement due to avascular necrosisAvascular necrosis of the femoral head?ANFH?is due to different causes leading to the destruction of the blood supply to the femoral head,which in turn causes bone degeneration and necrosis below the articular cartilage,which leads to collapse of the femoral head of the patient and eventually degenerative disruption of the hip joint of the patient change.Clinical application of MRI,DR,CT,etc.as an important imaging diagnosis of avascular necrosis of the imaging method,which MRI can be any direction imaging,and high resolution of femoral head disease,avascular necrosis of the femoral head Early diagnosis can be based on the examination results to make imaging diagnosis.The current domestic and international studies confirm[7-12],in the occurrence and development of avascular necrosis of the femoral head,the main pathophysiological manifestations of local articular cartilage and osteoblasts a large number of repair activities based on these repair activities Undertake a large number of secreted cytokines,localized in the femoral head,in these cytokines For example,TGF-?,BMP,PDGF,VEGF,IGF,basic fibroblast growth Factors?bFGF?and other interactions,the femoral head local repeated repair,and these repairs are usually pathological repair process.In conclusion,this study intends to provide a biochemical index for the severity of the change of the condition of patients with avascular necrosis of the femoral head by analyzing the changes of serum and synovial fluid related cytokines in patients with avascular necrosis of femoral head?ANFH?And then the early diagnosis of avascular femoral head,early intervention and treatment,improve patient quality of life.The main research topics include the following:Correlation between Ischemic Femoral Head Necrosis and Expression of VEGF BMP TGFStudy on the Correlation between Ischemic Femoral Head Necrosis and TheExpression of VEGF BMP TGFObjective:Combined with MRI,DR and other clinical imaging data,the diagnosis and classification of avascular necrosis of femoral head were first performed.Then the expression of related cytokines in peripheral blood and hip fluid of patients with avascular necrosis of the femoral head was analyzed and its clinical significance.Methods:In the experimental group,58 patients diagnosed as avascular necrosis of the femoral head from January 9 to March 9,2016 in Jingzhou Central Hospital were selected and then divided into early,middle and late stages according to Ficat clinical stage.The number of patients in early,middle and late stage was 26,18and14,peripheral blood serum and hip fluid of patients were collected and the content of TGF-?,BMP and VEGF were detected.In the control group,58 healthy volunteers of Jinghe Central Hospital Outpatient Medical Center The synovial fluid specimens were collected for detection of TGF-?,BMP and VEGF in serum and hip fluid.Results:Compared with the control group,the concentrations of TGF-?,BMP and VEGF in the peripheral blood serum and the hip fluid of the experimental group were significantly higher than those in the control group?P<0.05?.The data obtained by clinical classification and staging,The changes of TGF-?,BMP and VEGF levels with the severity of the disease increased,the statistical analysis of the difference?P<0.05?;BMP was significantly increased in the early,mid-term and late concentrations did not change significantly?P<0.05?.;Conclusion:Related cytokines are involved in the formation and development of avascular necrosis of the femoral head.TGF-?,BMP and VEGF can be used as effective indicators to evaluate the severity of ischemic necrosis of the femoral head in the process of avascular necrosis of the femoral head. |
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