性别对金属对金属全髋表面置换术后血清钴铬钼离子水平的影响  

Gender difference in metal ion levels following metal-on-metal resurfacing hip arthroplasty

作　　者：王伟[1] 刘璠[1] 刘华[1] 陶然[1] 杨洪伟[1] 刘雅克[1] 

机构地区：[1]南通大学附属医院骨科,226001

出　　处：《中华创伤骨科杂志》2015年第5期379-383,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨性别对金属对金属全髋表面置换术（RHA）后血清钴、铬、钼离子水平的影响. 方法 收集2008年11月至2013年3月因交通伤导致的24例单侧股骨头骨折患者,根据性别不同分为两组：男性组12例,平均年龄为（54.7±5.9）岁,股骨头骨折分型：31-C1型5例,31-C2型7例;女性组12例,平均年龄为（53.9±5.8）岁,股骨头骨折分型：31-C1型6例,31-C2型6例.所有患者均行金属对金属RHA治疗.分别于术前、术后3个月、6个月、9个月及12个月应用电化学微量元素测定法测量患者血清中钴、铬、钼离子的浓度,并比较两组患者的差异. 结果 男性组和女性组患者术后血清钴、铬离子浓度明显升高,术后6个月达到高峰,此后开始下降.男性组患者术后3、6、9及12个月时血清钴离子浓度平均分别为（1.37±0.50）、（2.51 ±0.78）、（1.99±0.46）、（1.26±0.60）μg/L,铬离子浓度平均分别为（0.98 ±0.18）、（1.39±0.44）、（1.12±0.21）、（0.74±0.15） μg/L.女性组患者术后血清钴离子浓度平均分别为（1.23±0.59）、（2.17 ±0.82）、（1.79 ±0.43）、（1.23±0.11）μg/L,铬离子浓度平均分别为（0.90 ±0.20）、（1.19±0.31）、（1.03±0.20）、（0.74±0.17）μg/L.两组患者术后3、6、9及12个月血清钼离子浓度无明显变化.除了术后9个月男性组患者铬离子浓度显著高于女性组患者（P＜0.05）外,其他时间点两组患者钴、铬、钼离子浓度比较差异均无统计学意义（P＞0.05）. 结论 除术后9个月男性患者铬离子浓度显著高于女性患者外,其他时间点男性与女性患者钴、铬、钼离子浓度差异不明显.Objective To study the effect of gender on the serum ion levels of Co,Cr and Mo in the patients who have undergone metal-on-metal resurfacing hip arthroplasty.Methods Enrolled in the present study were 24 patients with fracture of uni-lateral femoral head who were injured from November 2008 to March 2013 in traffic accidents.There were 12 men,with an average age of 54.7 ± 5.9 years,including 5 cases of type 31-C1 and 7 cases of 31-C2.There were also 12 women,with an average age of 53.9 ±5.8 years,including 6 cases of type 31-C1 and 6 cases of 31-C2.All the patients received metal-on-metal resurfacing hip arthroplasty.The ion levels of Co,Cr and Mo in the serum of the patients were measured by electrochemical trace element determination at 3,6,9 and 12 months after surgery for comparison between the male and female groups.Results The ion concentrations of Co and Cr in both groups significantly increased and then decreased after reaching the peak at 6 months post-surgery.In the male group at 3,6,9 and 12 months after surgery,the Co levels were respectively 1.37 ±0.50 μg/L,2.51 ±0.78 μg/L,1.99 ± 0.46 μg/L and 1.26 ±0.60 μg/L and the Cr levels were respectively 0.98 ±0.18 μg/L,1.39 ±0.44 μg/L,1.12±0.21 μg/L and 0.74±0.15 μg/L.In the female group at 3,6,9 and 12 months after surgery,the Co levels were respectively 1.23 ±0.59 μg/L,2.17 ±0.82 μg/L,1.79 ±0.43 μg/L and 1.23 ±0.11 μg/L and the Cr levels were respectively 0.90 ±0.20 μg/L,1.19 ±0.31 μg/L,1.03 ±0.20 μg/L and 0.74 ± 0.17 μg/L.There was no significant change in the ion concentration of Mo in either male or female groups after surgery.No significant differences were found in the ion levels of Co,Cr or Mo after surgery between the 2 groups （P 〉 0.05） except that the Cr ion level in the male patients was significantly higher than that in the female patients at 9 months after surgery （P 〈 0.05）.Conclusion No significant differences can be found in the ion levels of Co,Cr or Mo after surgery between males and females exc

关 键 词：关节成形术 置换 髋 性别因素 血清 金属 重 离子 

分 类 号：R687.4[医药卫生—骨科学]