Changes of serum COMP and MMP13 levels in patients with ischemic necrosis of femoral head and their clinical significances

YE Woqiu; FENG Yixin

doi:10.3969/j.issn.1674-666X.2015.06.005

Abstract：Objective To observe the changes of serum levels of cartilage oligomeric matrix protein (COMP) and matrix metalloproteinase 13 (MMP13) in patients with ischemic necrosis of femoral head (INFH), and to explore their clinical significances. Methods A total of 38 patients with INFH after femoral neck fracture surgery in Puning People's Hospital from January 2012 to January 2015 were randomly selected as observation group. At the same time, 30 patients without INFH after femoral neck fracture surgery were selected as operation control group and 30 healthy persons were collected as healthy control group. Patients in observation group were performed core decompression, and serum COMP and MMP13 levels at 1, 3, 5, 7, 10 d postoperatively were examined by ELISA method; Meanwhile, serum levels of COMP and MMP13 in other 2 groups were also detected. In observation group, relationships between serum COMP, MMP13 levels and postoperative Harris scores were analyzed, and ROC curve analysis was applied to evaluate the predicting value of combined examination of serum COMP and MMP13 levels for hip joint function recovery in INFH patients. Results Serum COMP and MMP13 levels in observation group before treatment were (13.5 ± 2.4) U/L and (45.5 ± 2.2) μg/L respectively, which were higher than (8.5 ± 1.5) U/L, (34.4 ± 1.9)μg/L in operation control group and (5.2 ± 1.1) U/L, (27.2 ± 1.4) μg/L in healthy control group;The above parameters in operation control group were all higher than those in healthy control group (P <0.05). Compared with preoperative results, serum COMP and MMP13 level at 5, 7 and 10 days postoperatively were lower (P<0.05) in observation group; Harris score at 1, 3 months postoperatively was 87 ± 7 and 94 ± 3 respectively, and hip joint function were excellent in 12 patients, good in 17, fair in 6 and poor in 3 at 3 months after the surgery, with the excellent and good rate of 76% (29/38). Serum COMP and MMP13 levels in patients with excellent and good hip joint function recovery were lower than those in patients with fair or poor function recovery (P <0.05). ROC analysis results showed that when serum COMP and MMP13 level cutoff value was 13.14 U/L + 44.85 μg/L, the sensitivity, specificity, positive predictive value and negative predictive value was 97%, 89%, 97% and 89% respectively, which had highest prognostic value. Conclusions Serum COMP and MMP13 levels in INFH patients are relative high which were closely related to their hip functions, and the combined examination has good value in predicting the early recovery of hip joint functions.