微量元素与髋假体周围骨融合的相关性  

Correlation of trace elements and bone fusion surrounding hip prosthesis

作　　者：傅晓东[1] 王伟力[1] 沈奕[1] 李晓淼[1] 

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海市200127

出　　处：《中国组织工程研究》2015年第17期2677-2682,共6页Chinese Journal of Tissue Engineering Research

基　　金：上海市浦东新区卫生局卫生科技项目(PW2012D-2)~~

摘　　要：背景:髋关节置换后假体的融合率与假体周围的骨重建过程密切相关,此过程受假体周围患者本身的因素影响。微量元素与成骨密切相关,故假体周围微量元素的含量可能影响髋关节假体的骨融合与生存率。目的:分析股骨近端微量元素与髋假体周围骨融合的相关性。方法:纳入24例初次全髋关节置换的患者,取术中股骨矩开槽时废弃骨块,体外细胞培养后检测微量元素钙、镁、锌、甲状旁腺素、活性维生素D3,置换后通过双能X射线吸收法骨密度仪随访第1周、3个月、6个月的假体周围骨密度。比较不同年龄、不同性别患者微量元素的差异,分析以上5项微量元素与骨密度之间的相关性。结果与结论:各微量元素水平在不同年龄组及不同性别组间差异无显著性意义(P>0.05)。锌与甲状旁腺素、镁呈正相关性(P<0.05),锌与第7区骨密度呈正相关性(P<0.05)。对于股骨近端微量元素的进一步研究可以用来预测和干预髋关节假体的寿命。BACKGROUND： The prosthesis fusion rate after total hip replacement is closely related to the reconstruction process of bone, which is affected by the factors around the implant of patient. Trace elements are strongly associated with the ossification. Thus, the content of trace elements in proximal femur may affect the bone fusion and survival rate of the prosthesis. OBJECTIVE： To analyze the correlation of trace elements and bone fusion surrounding the prosthesis in proximal femur. METHODS： Bone samples were obtained from the discarded metaphysis region of the proximal femur in 24 patients with primary total hip replacement. Trace element （calcium, magnesium, zinc, parathyroid hormone, activated vitamin D3） contents were detected after vitro cell culture. Bone mineral density was tested surrounding the prosthesis at 1 week, 3 and 6 months after replacement by dual energy X-ray absorption method with a bone density meter. The difference in trace elements was compared in patients at different ages and different genders. The correlation between above five kinds of trace elements and bone mineral density was analyzed. RESULTS AND CONCLUSION： No significant difference in trace element contents was detected in different age groups and different gender groups （P 〉 0.05）. Zinc content was positively correlated with parathyroid hormone and magnesium contents （P 〈 0.05）. Zinc was positively associated with bone mineral density in the region 7 （P 〈 0.05）. The further studies concerning the trace elements in proximal femur can be used to predict and intervene in the longevity of hip prosthesis.

关 键 词：关节成形术 置换 髋 锌 骨密度 植入物 人工假体 微量元素 髋关节置换 骨重建 

分 类 号：R318[医药卫生—生物医学工程]