摘要
目的探讨老年胫骨骨折患者血清β-Ⅰ型胶原羧基端肽(β-CTX)、碱性磷酸酶(ALP)、胰岛素样生长因子-1(IGF-1)、人可溶性细胞间黏附分子-1(sICAM-1)水平与患者骨痂形成的关系。方法选取2018年1月至2021年3月澄迈县人民医院采用切开复位内固定手术治疗的胫骨骨折患者123例,对123例患者进行随访,根据患者是否发生骨折延迟愈合分为延迟组30例、正常愈合患者93例(对照组);对比两组患者手术前后不同时间点的X线骨痂评分、血清ALP、IGF-1、sICAM-1及β-CTX水平;采用多元线性回归方法分析X线骨痂评分与患者的年龄、性别、BMI及血清ALP、IGF-1、sICAM-1、β-CTX的关系。结果延迟组患者术后1个月、术后2个月的骨痂Ⅹ线评分均显著低于对照组,差异具有统计学意义(P<0.05);术前,延迟组和对照组的血清ALP、IGF-1、sICAM-1、β-CTX比较差异无统计学意义(P>0.05);术后2个月,延迟组患者的血清sICAM-1高于对照组,血清ALP、IGF-1、β-CTX低于对照组,差异均有统计学意义(P<0.05);多元线性回归分析结果显示:老年下肢胫骨骨折患者骨痂Ⅹ线评分与ALP、IGF-1、β-CTX呈正相关(P<0.05)、与术后感染、sICAM-1呈负相关(P<0.05)。结论老年患者胫骨骨折术后ALP、IGF-1、β-CTX水平及sICAM-1水平变化可能与骨痂形成有关。
Objective To investigate the relationship between serumβ-CTX,ALP,IGF-1,sICAM-1 levels and callus formation in elderly patients with tibial fractures.Methods A total of 123 patients with tibial fractures treated by open reduction and internal fixation in Chengmai County People’s Hospital from January 2018 to March 2021 were selected,123 patients were followed up,and they were divided into the delayed group of 30 cases according to whether the patients had delayed fracture union.93 patients with normal healing(control group);The X-ray callus scores,serum ALP,IGF-1,sICAM-1 andβ-CTX levels at different time points before and after surgery were compared between the two groups.Multiple linear regression method was used to analyze the relationship between X-ray callus score and age,gender,BMI and serum ALP,IGF-1,sICAM-1 andβ-CTX.Results The callus X-line scores of patients in the delayed group at 1 month and 2months after operation were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).Before surgery,there was no significant difference in serum ALP,IGF-1,sICAM-1 andβ-CTX between the delay group and the control group(P>0.05);Two months after operation,the serum s ICAM-1 in the delayed group was higher than that in the control group(P<0.05),and the serum ALP,IGF-1 andβ-CTX were lower than those in the control group,and the difference was statistically significant(P<0.05).The results of multiple linear regression analysis showed that the callus X-line score was positively correlated with ALP,IGF-1 andβ-CTX in elderly patients with lower extremity tibial fractures(P<0.05),and negatively correlated with postoperative infection and sICAM-1(P<0.05).Conclusion The changes of ALP,IGF-1,β-CTX and sICAM-1 levels in elderly patients after tibial fracture may be related to callus formation.
作者
陈锦富
吴多庆
陈余兴
CHEN Jinfu;WU Duoqing;CHEN Yuxing(Department of Orthopedics,Chengmai People's Hospital,Chengmai,Hainan,China,571900;Department of Rehabilitation and Reconstruction,Orthopaedic Medical Center,Haikou Hospital Affiliated to Xiangya Medical College,Central South University,Haikou,Hainan,China,570208;Department of Orthopedics,Hainan West Central Hospital,Danzhou,Hainan,China,571700)
出处
《分子诊断与治疗杂志》
2022年第3期521-524,共4页
Journal of Molecular Diagnostics and Therapy
基金
海南省卫生计生行业科研项目(13A210274)。
