髋关节置换前后髋关节功能与维生素D水平的多元线性回归分析  

Multiple linear regression analysis of hip function and vitamin D levels before and after hip arthroplasty

作　　者：张炜[1] 汤在祥[2] 耿德春[1] 朱锋[1] 董汉青 王熠军 徐耀增[1] 

机构地区：[1]苏州大学附属第一医院骨科,江苏省苏州市215006 [2]苏州大学医学部公共卫生学院,江苏省苏州市215123

出　　处：《中国组织工程研究》2016年第44期6557-6563,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81372018);国家自然科学基金资助项目(81472077)~~

摘　　要：背景:髋关节置换患者中维生素D低水平的发病率及其影响国内尚未有过报道。全髋关节置换的患者维生素长期处于低水平状态没有受到足够的重视。目的:确定接受全髋关节置换患者置换前维生素D低水平的患病率,分析置换前维生素D水平与髋关节功能评分之间的关系。方法:纳入一医院行初次髋关节置换的患者2013年7月至2014年8月在苏州大学附属第45例45髋。根据置换前血浆维生素D水平将患者分为维生素D低水平组(<20μg/L)和维生素D高水平组(≥20μg/L)。观察并比较2组患者的一般情况、置换前及置换后末次随访时的髋关节功能评分,采用多元线性回归分析法分析维生素D水平与髋关节置换前后髋关节功能的关系。随访时间11-14个月。结果与结论:(1)维生素D低水平的患病率为82%(使用20μg/L为标准);(2)与维生素D高水平组相比,维生素D低水平组置换前Harris评分和Merle d’Aubigne-Postel评分更低(P均<0.05);置换后末次随访时,维生素D低水平组Harris评分和Merle d’Aubigne-Postel评分仍然低于维生素D高水平组(P均<0.05);(3)通过对置换前、置换后Harris评分行多元线性回归分析,置换前维生素D水平与置换前、置换后的Harris评分呈紧密正相关,且有统计学意义(P<0.05);(4)结果提示,髋关节置换患者有着较高的维生素D低水平发病率,且维生素D低水平组置换前、置换后髋关节功能评分较维生素D高水平组低,维生素D水平和置换前、置换后关节功能评分之间呈紧密正相关性。建议髋关节置换患者常规补充维生素D、钙;维生素D水平对于患者的病情评价、术后预期有一定指导意义。BACKGROUND：The incidence of low serum level of vitamin D in patients undergoing hip arthroplasty and its impact has not been reported in China, indicating that it has not been brought to the forefront. OBJECTIVE：To determine the prevalence of low serum level of vitamin D in patients before total hip arthroplasty and its relationship with the hip function scores. METHODS：Forty-eight hips from 48 patients undergoing primary hip arthroplasty from July 2013 to August 2014 in the First Affiliated Hospital of Suzhou University were enrol ed. According to the serum level of vitamin D, patients were assigned to low-level （〈20μg/L） and high-level （20≥μg/L） groups. The general information of patients, the hip function scores before and after replacement at the last fol ow-up in the two groups were observed and compared. The relationship between the serum level of vitamin D and the hip function scores before and after replacement was analyzed by multiple linear regression analysis. And the average fol ow-up was 12 months （11-14 months）. RESULTS AND CONCLUSION：（1） The incidence of low vitamin D level was 82%（20 ng/mL serving as standard）. （2） Compared with patients with high vitamin D level, patients with low level of vitamin D had lower preoperative Harris scores and Merle D′Aubigne-Postel score （P〈0.05）, and also at the last fol ow-up （P〈0.05. （3） Based on the preoperative and postoperative Harris, the multiple linear regression analysis showed that there was a positive correlation between the level of vitamin D and Harris score both preoperatively and postoperatively （P〈0.05）. （4） These results suggest that there is a higher incidence of low level of vitamin D in patients undergoing arthroplasty, and hip function scores before and after replacement in patients with low level of vitamin D are lower than the high level patients. Moreover, there is a positive correlation between the level of vitamin D and the hip joint function scores. Therefore, it is advisable

关 键 词：关节成形术 置换 髋 假体植入 随访研究 组织工程 骨科植入物 人工假体 维生素D 全髋关节置换 髋关节功能评分 多元线性回归分析 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]