老年髋部骨折类型同胰岛素样生长因子及其结合蛋白表达的相关性研究  

Correlation of senile hip fracture type with expressions of insulin-like growth factor and its binding proteins

作　　者：梁朝革[1] 陈豪杰[1] 岳雄[1] 王嘉[1] 徐刚[1] 张鹏[1] 

机构地区：[1]上海市长宁区中心医院骨科,200036

出　　处：《中华创伤杂志》2011年第6期541-544,共4页Chinese Journal of Trauma

摘　　要：目的研究不同类型老年女性髋部骨折中外周、局部IGF—Ⅰ及IGFBP-3，4，5表达差异及相关性。方法选取年龄大于65岁老年女性髋部骨折患者，比较外周及局部IGF—Ⅰ及IGFBP-3，4，5表达差异及其相关性。结果共收集46例患者血清及局部指标，粗隆问骨折组粗隆区BMD较股骨颈骨折组低（P〈0．001），股骨颈组血清及局部IGFBP-4含量较粗隆间骨折组低（P〈0．001），而IGF—Ⅰ及IGFBP-3，5含量高于粗隆间骨折组（P〈0．001）。局部蛋白同血清指标无相关性，相同指标fHJ只有局部IGFBP-4mRAN同血清相关指标成正相关（R：0．544，P〈0．001）。结论外周血清及局部中IGF—Ⅰ及其结合蛋白表达的差异可能是导致不同类型老年髋部骨折的病理机制之一，但除IGFBP-4外，其他因子可能通过不同的调节机制影响老年髋部局部的骨代谢。Objective To study the expression difference of the insulin-like growth factor- I （IGF- I ） and IGF-binding proteins-3,4,5 （IGFBP-3,4,5）in the peripheral and local areas in senile hip fracture and discuss the correlation between the expression and the fracture types. Methods The study involved the senile patients （over 65 years） with hip fractures to compare the expressions of peripheral and local IGF- I and IGFBP-3,4,5 and observe the correlation between expression and fracture type. Results The serum and local specimens of 46 patients were collected, with lower level of BMD, IGF- I and IGFBP-3,5 in the intertrochanteric fracture group than the femoral neck fracture group （P 〈 0. 001 ） and with higher level of serum and local IGFBP-4 in the intertrochanteric fracture goup than the femoral neck fracture group （ P 〈 0.001 ）. Only local IGFBP-4 mRNA had positive correlation with serum markers （ R = 0. 544,P 〈 0. 001 ）. Conclusions The expression difference of IGF- I and IGFBP in the peripheral and local serum may be one of pathogenesis leading to different types of hip fractures. Except for the IGFBP4, the other factors may affect the bone metabolism of the senile hip fractures through different regulatory mechanisms.

关 键 词：髋部骨折 血清胰岛素样生长因子Ⅰ 血清胰岛素样生长因子结合蛋白3 4 5 

分 类 号：R686[医药卫生—骨科学]