Zalavras C, Dailiana Z, Elisaf M, Bairaktari E, Vlachogiannopoulos P, Katsaraki A, Malizos K N
University of Ioannina, Ioannina; University of Athens, Athens; University Hospital of Ioannina, Ioannina; University of Thessalia, Larissa, Greece.
Eur J Clin Invest. 2000 Mar;30(3):215-21. doi: 10.1046/j.1365-2362.2000.00621.x.
The aetiology and pathogenesis of non-traumatic osteonecrosis (ON) of the femoral head have not been fully elucidated. The present study was conducted to evaluate the possible correlation of relevant haematological and biochemical factors with the development of ON.
Our investigation consisted of measurement of haematological indices and assessment of the biochemical and lipid profile of a study population of 68 patients with non-traumatic ON of the femoral head and 36 healthy controls. The disease was considered idiopathic in 17 and secondary in 51 patients.
There were no statistically significant differences in the parameters measured among the idiopathic ON, secondary ON and control groups, except for globulins alpha1, alpha2 and beta, which were significantly increased in both patient groups, and apolipoprotein B (Apo B), which was increased in patients with idiopathic disease compared with the control group. Both patient groups presented increased von Willebrand factor (VWF) and lipoprotein (a) [Lp(a)] levels and decreased protein C and S concentrations, but without statistical significance. However, both patient groups exhibited a greater proportion of abnormal values of any of these parameters, in 58.9% of the idiopathic and in 62.7% of the secondary ON patients, compared with 8.3% of the controls.
Our study underlines the potential association of abnormal values of protein C, protein S, VWF and Lp(a) with ON. To our knowledge this is the first reported association of VWF with the disease. The majority of both idiopathic and secondary ON patients in our series exhibits a thrombotic potential that adds further support to the postulation that intravascular coagulation is a major pathogenetic mechanism leading to the disease.
股骨头非创伤性骨坏死（ON）的病因和发病机制尚未完全阐明。本研究旨在评估相关血液学和生化因素与ON发生之间的可能相关性。
我们的调查包括对68例股骨头非创伤性ON患者和36例健康对照者的研究人群进行血液学指标测量以及生化和血脂谱评估。17例患者的疾病被认为是特发性的，51例为继发性的。
在特发性ON组、继发性ON组和对照组之间，所测参数无统计学显著差异，但球蛋白α1、α2和β在两组患者中均显著升高，载脂蛋白B（Apo B）在特发性疾病患者中较对照组升高。两组患者的血管性血友病因子（VWF）和脂蛋白（a）[Lp（a）]水平均升高，蛋白C和S浓度降低，但无统计学意义。然而，与对照组的8.3%相比，两组患者中这些参数出现异常值的比例更高，特发性ON患者中为58.9%，继发性ON患者中为62.7%。
我们的研究强调了蛋白C、蛋白S、VWF和Lp（a）异常值与ON之间的潜在关联。据我们所知，这是首次报道VWF与该疾病的关联。我们系列中的大多数特发性和继发性ON患者都具有血栓形成倾向，这进一步支持了血管内凝血是导致该疾病的主要发病机制这一假设。
