骨纤维异常增殖症患者血清骨膜素水平与骨畸形进展的关系

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Abstract Objective Fibrous dysplasia (FD) is a rare benign progressive disease of bone，which is often complicated by the progression of Shepherd’s crook deformity.The aim of this study was to analyze the relationship between serum Periostin (PN) and the progression of bone deformities in FD patients.Methods From January 2011 to September 2018，159 FD patients were collected in the Department of Orthopaedics of Baoding Second Hospital，including 49 males and 110 females.The average age was (28.16±20.08) years，ranging from 5 to 58 years.There were 127 cases of single bone FD and 32 cases of multiple bone FD.Serum samples were collected 24 hours before operation and 7 days after operation.In addition，200 healthy volunteers were included as the control group，including 70 males and 130 females.The average age was (25.44±17.32) years.Serum samples were collected.Sandwich enzyme linked immunosorbent assay was used to detect the serum PN levels in the two groups.Univariate and multivariate COX regression analysis was used to determine the risk factors of Shepherd’s crook deformity.Results The serum PN level in FD group was significantly higher than that in control group (P＜0.05).In univariate factor analysis，age，lesion location，lesion type，the progress of Shepherd’s crook deformity were closely related to serum PN level before operation (P＜0.05).By univariate and multivariate factor analysis，multiple Bone FD (OR：4.592，95% CI：1.610～13.102，P＝0.004) and abnormal serum PN (OR：6.596，95% CI：2.177～19.983，P＝0.001) were the independent risk factors for the occurrence of Shepherd’s crook deformity (P＜0.05).The overall analysis showed that the serum PN level after operation in FD group was lower than that before operation (P＝0.005).There was a significant difference in the trend of serum PN levels between FD patients with and without bone deformity(P＜0.05)，the postoperative serum PN level of patients with bone malformation progression was also higher than that of FD patients without bone malformation progression (P＜0.05).Conclusion The multiple bone FD patients with higher serum PN levels have a clear trend of bone deformity progression.Monitoring serum PN is helpful to predict the progression of Shepherd’s crook deformity.

Key words： fibrous dysplasia surgery serum periostin shepherd’s crook deformity

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