骨折围手术期血清25羟维生素D及钙水平变化的研究  

Study on the change of serum 25 hydroxy vitamin D and calcium levels during perioperativeperiod of fractures

作　　者：李长洲[1] 于利[1] 汤欣[1] 刘谟震[1] 陈超[1] 

机构地区：[1]大连医科大学附属第一医院创伤骨科,大连116011

出　　处：《中国骨质疏松杂志》2015年第5期618-623,共6页Chinese Journal of Osteoporosis

摘　　要：目的：研究骨折围手术期血清25羟维生素D[25（OH）D]及钙水平变化及其意义。方法选取骨折手术患者160例，其中男77例，女83例；年龄30～90岁，平均年龄（59.4±16.9）岁；93例为低能量损伤，67例为高能量损伤；均于伤后1～5天手术。分别于骨折后第一天及手术后第一天晨起测定空腹血清25（OH）D及血清钙水平。同期选取门诊健康体检者150例为对照组进行统计分析。结果1．围手术期血清钙水平较对照组降低，术后较术前进一步降低，差异均有统计学意义（ P＜0.05），除手术后血清钙水平略低于正常范围外，其余均在正常水平范围内波动；不同年龄及性别组间差异无统计学意义（ P＞0.05）；2．对照组、术前和术后血清25（OH）D水平分别为（18.2±5.18）ng／ml、（12.24±7.46）ng／ml和（8.85±6.21）ng／ml。术前比对照组降低32.7％，术后比术前降低27.7％，其差异均具有统计学意义（P＜0.05）。3．围手术期血清25（OH）D水平随着年龄增长呈下降趋势，女性较男性血清25（OH）D水平明显降低，差异均有统计学意义（P＜0.05）。4．在30～50岁组中高能量损伤血清25（OH）D水平比低能量损伤明显降低，50～70岁组和70～90岁组低能量比高能量损伤血清25（OH）D水平明显降低，其差异均有统计学意义（P＜0.05）。5．围手术期血清25（OH）D水平与血清钙水平无相关性（P＞0.05）。结论1．维生素D水平在骨折后明显不足，手术后进一步加重，可能与骨折消耗或参与骨折修复有关。2．年龄、性别、损伤程度对围手术期维生素D水平变化均有影响。3．骨折后围手术期应早期持续补充足量的维生素D和适量钙。Objective To study the serum 25 hydroxy vitamin D [25（OH）D] and calcium changes and the significance during perioperative period of fractures.Methods One hundred and sixty patients with traumatic fracture operation were selected, including 77 males and 83 females with ages from 30 to 90 years old, mean age 59.4 ±16.9 years.Among them, 93 cases were caused by low energy injury, and 67 cases were caused by high energy injury.The operation was performed in 1-5 days after the fracture.Fasting serum calcium and 25 （ OH） D were measured in the first day after fracture and the morning of the operation.At the same period 150 healthy people from outpatient were selected as control group for statistical analysis.Results 1 ） During perioperative period serum calcium level was lower than that in the control group.Serum calcium decreased further after the operation, and the difference was statistically significant （P〈0.05）.Except serum calcium level was below the normal range after the operation, the rest were within the normal range.No statistical difference was found among different age and gender groups （ P〉0.05）.2） Serum 25 （OH） D levels in the control group, preoperative, and postoperative were 18.2 ±5.18 ng/ml, 12.24 ± 7.46 ng/ml, and 8.85 ±6.21 ng/ml, respectively.The level was 32.7%lower in preoperative than in the control group, 27.7%lower in postoperative than in preoperative, and the differences were statistically significant （P〈0.05）.3） Serum 25 （OH） D level decreased with age during perioperative, and it was lower in females than in males with significantly difference （P〈0.05）. 4） 25 （OH） D levels in 30-50-year group were significantly lower in high energy injury group than in low energy injury group. However, in 50-70-year group and in 70-90-year group 25 （ OH） D levels were lower in low energy injury group than in high energy group.The difference was statistically significant （p〈0.05） 5） Serum 25 （OH） D levels were not correlated with serum

关 键 词：骨折 围手术期 25羟维生素D 钙 

分 类 号：R681[医药卫生—骨科学]