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目的研究股骨头坏死患儿患髋的生物化学改变，分析关节功能状态在疾病中所起的作用。方法本实验运用放射免疫学方法检测了２０例儿童股骨头坏死患髓软骨，１０例与患儿年龄相当的尸体同部位软骨的蛋白多糖（ＰＧ）三组份：氨基己糖、己糖醛酸、硫酸基含量和患儿关节腔液及外周血清透明质酸（ＨＡ）含量，并分别与正常对照组相比较，同时分析软骨ＰＧ、关节腔液和血清ＨＡ三者相互之间的相关性。结果①儿童股骨头坏死患儿软骨ＰＧ三组份含量较正常对照明显下降（Ｐ＜０．０１）；②股骨头坏死患儿血清ＨＡ浓度明显高于正常对照组（Ｐ＜０．０１），关节腔液ＨＡ与血清ＨＡ呈负相关（ｒ＝－０．６６３，Ｐ＜０．０５）；③股骨头坏死患儿关节腔液ＨＡ浓度与软骨ＰＧ含量均呈正相关（ｒ＝０．６８２，Ｐ＜０．０５）；软骨ＰＧ含量与血清ＨＡ浓度呈负相关（ｒ＝－０．６３２，Ｐ＜０．０５）。结论①儿童股骨头坏死患髓关节功能有明显障碍；②血清ＨＡ对于儿童股骨头坏死病可在一定程度上反映软骨功能状态；③关节功能障碍与股骨头坏死病变相互促进，恶性循环。
Objective To study the biochemical changes of hip in children with femoral head necrosis and to analyze the role of joint function in the disease. Methods In this study, 20 cases of children with osteonecrosis of the femoral head were detected by radioimmunoassay, and 10 cases of proteoglycans (PG) with the same site of cartilage in the same age group were treated with three components: hexosamine, hexuronic acid , Content of sulfate group and content of joint cavity fluid and hyaluronic acid (HA) in peripheral blood of children were compared with normal control group respectively. Meanwhile, the correlation between cartilage PG, articular cavity fluid and serum HA were also analyzed. Results ① The content of PG three components in cartilage of children with femoral head necrosis was significantly lower than that of the normal control group (P <0.01); ② The serum HA level of children with femoral head necrosis was significantly higher than that of the normal control group (P <0.01) There was a negative correlation between HA in the articular cavity fluid and serum HA (r = -0.663, P <0.05); ③ The HA concentration in articular cavity fluid was positively correlated with cartilage PG content in children with femoral head necrosis (r = 0.682, P <0.05). PG content in cartilage was negatively correlated with serum HA concentration (r = -0.632, P <0.05). CONCLUSIONS ① There is a significant obstacle to the function of marrow joint in children with femoral head necrosis; ② Serum HA can reflect the functional status of cartilage to a certain extent in children with osteonecrosis of the femoral head; ③The joint dysfunction and the pathological changes of femoral head necrosis mutually promote and vicious cycle.