骨生化代谢标志物动态监测在预测老年股骨近端骨折延迟愈合中的价值
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摘要
目的探讨骨代谢生化标志物动态监测对老年股骨近端骨折延迟愈合的预测价值。方法选取该院2015年2月至2017年2月收治的股骨近端骨折正常愈合、延迟愈合老年患者各54例,分别作为对照组与观察组,测定并比较两组骨折后24h,1、4、8、12周的血清骨生化代谢标志物[骨钙素(BGP)、Ⅰ型胶原氨基端前肽(PⅠNP)、碱性磷酸酶(ALP)、胰岛素生长因子1(IGF-1)]水平。结果观察组骨折后8周血清BGP水平高于对照组,PⅠNP、IGF-1水平均低于对照组,差异均有统计学意义(P<0.05);观察组骨折后12周BGP、PⅠNP、ALP、IGF-1与骨折后24h的比值与对照组比较,差异均有统计学意义(P<0.05)。结论术后12周BGP、PⅠNP、ALP等骨生化代谢标志物检测对老年股骨近端骨折延迟愈合有一定的预测价值。
Objective To investigate the value of dynamic monitoring of biochemical markers of bone metabolism in predicting delayed healing of proximal femoral fractures in elderly patients.Methods A total of 54 elderly patients with normal healing and 54 elderly patients with delayed healing of proximal femoral fractures treated in the hospital from February 2015 to February 2017 were enrolled in the study,which were set as the control group and the observation group,respectively.Concentrations of serum biochemical markers of bone metabolism including bone gla protein(BGP),procollagenⅠ N-terminal peptide(PⅠNP),alkaline phosphatase(ALP),insulin-like growth factor 1(IGF-1)in the two groups were determined and compared at 24 h,1 week,4 weeks,8 weeks and 12 weeks after fractures.Results The serum BGP concentration of observation group were significantly higher than that of control group,and concentrations of PⅠNP and IGF-1 were significantly lower in the observation group than the control group at 8 weeks after fractures(P<0.05).There were significant differences in the ratios of BGP,PⅠNP,ALP,and IGF-1 between the observation group and the control group at 12 weeks after fractures(P<0.05).Conclusion The detection of biochemical markers of bone metabolism such as BGP,PⅠNP and ALP has certain value in predicting delayed healing of proximal femoral fractures in the elderly patients.
Objective To investigate the value of dynamic monitoring of biochemical markers of bone metabolism in predicting delayed healing of proximal femoral fractures in elderly patients.Methods A total of 54 elderly patients with normal healing and 54 elderly patients with delayed healing of proximal femoral fractures treated in the hospital from February 2015 to February 2017 were enrolled in the study,which were set as the control group and the observation group,respectively.Concentrations of serum biochemical markers of bone metabolism including bone gla protein(BGP),procollagenⅠ N-terminal peptide(PⅠNP),alkaline phosphatase(ALP),insulin-like growth factor 1(IGF-1)in the two groups were determined and compared at 24 h,1 week,4 weeks,8 weeks and 12 weeks after fractures.Results The serum BGP concentration of observation group were significantly higher than that of control group,and concentrations of PⅠNP and IGF-1 were significantly lower in the observation group than the control group at 8 weeks after fractures(P<0.05).There were significant differences in the ratios of BGP,PⅠNP,ALP,and IGF-1 between the observation group and the control group at 12 weeks after fractures(P<0.05).Conclusion The detection of biochemical markers of bone metabolism such as BGP,PⅠNP and ALP has certain value in predicting delayed healing of proximal femoral fractures in the elderly patients.
引文
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[11]MOGHADDAM A,MULLER U,ROTH H J,et al.TRACP 5band CTX as osteological markers of delayed fracture healing[J].Injury,2011,42(8):758-764.
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[13]KATANO M,NARUSE K,UCHIDA K,et al.Low intensity pulsed ultrasound accelerates delayed healing process by reducing the time required for the completion of endochondral ossification in the aged mouse femur fracture model[J].Exp Anim,2011,60(4):385-395.
[14]王清华,林坚平,沈宁江,等.根据Ⅰ型胶原氨基端末肽,Ⅰ型胶原羧基端末肽,骨钙素及骨特异性碱性磷酸酶早期诊断骨不连[J].中国组织工程研究,2016,20(51):7611-7621.
[15]张琼美,张秀军.血流变学指标及血清人可溶性细胞间黏附分子1、可溶性血管细胞黏附分子1、胰岛素样生长因子、血小板衍生生长因子水平在骨折延迟愈合患者中的临床意义[J].中国医药导报,2013,10(27):43-45.
[2]高全有,杨涛,蔺啸,等.骨折延迟愈合血清指标及微循环指标的变化研究[J].广西医学,2014,36(11):1582-1584.
[3]闫献雨,赵治邦,樊文良,等.血清黏附分子及微量元素与胫腓骨骨折延迟愈合的关系分析[J].海南医学院学报,2017,23(1):107-109.
[4]张红凤,卢海景,饶华春,等.不同骨折部位骨代谢生代指标回顾性分析[J].国际检验医学杂志,2016,37(21):3083-3085.
[5]古荣.骨代谢生化指标测定在中老年骨质疏松症早期诊断中的应用研究[J].国际检验医学杂志,2014,35(23):3185-3186.
[6]刘永,顾大伟,殷国超,等.中老年人骨代谢生化标志物骨钙素测定的临床价值[J].中国实验诊断学,2015,19(8):1392-1393.
[7]宋敬锋,梁春雨,刘昊,等.强骨胶囊对老年股骨头近段骨折延迟愈合患者血清BMP-2及IGF-1水平的影响[J].现代生物医学进展,2017,17(7):1255-1258.
[8]张萌萌.中国老年学学会骨质疏松委员会骨代谢生化指标临床应用专家共识[J].中国骨质疏松杂志,2014,20(11):1263-1272.
[9]DELMAS P D.Biochemical markers of bone turnover for the clinical assessment of metabolic bone disease[J].Endocrinol Metab Clin North Am,1990,19(1):1-18.
[10]高长城,张晓瑞.四肢骨折延迟愈合患者微循环与骨代谢指标的变化[J].海南医学院学报,2014,20(8):1097-1099.
[11]MOGHADDAM A,MULLER U,ROTH H J,et al.TRACP 5band CTX as osteological markers of delayed fracture healing[J].Injury,2011,42(8):758-764.
[12]朱振标,张寿,金旭红,等.骨折延迟愈合患者IGF-1、PDGF、ALP、PINP、β-CTX水平变化的研究[J].重庆医学,2015,44(21):2915-2917.
[13]KATANO M,NARUSE K,UCHIDA K,et al.Low intensity pulsed ultrasound accelerates delayed healing process by reducing the time required for the completion of endochondral ossification in the aged mouse femur fracture model[J].Exp Anim,2011,60(4):385-395.
[14]王清华,林坚平,沈宁江,等.根据Ⅰ型胶原氨基端末肽,Ⅰ型胶原羧基端末肽,骨钙素及骨特异性碱性磷酸酶早期诊断骨不连[J].中国组织工程研究,2016,20(51):7611-7621.
[15]张琼美,张秀军.血流变学指标及血清人可溶性细胞间黏附分子1、可溶性血管细胞黏附分子1、胰岛素样生长因子、血小板衍生生长因子水平在骨折延迟愈合患者中的临床意义[J].中国医药导报,2013,10(27):43-45.