骨折合并颅脑外伤患者血清bFGF、IGF-Ⅰ、SEMA 3水平与骨痂形成时间相关性研究  

To study the correlation of serum levels of b FGF,IGF-Ⅰ,SEMA 3A and callus formation time in patients with traumatic brain injury

作　　者：曾景 严远森 谷瑞辰 

机构地区：[1]广东省惠州市第三人民医院急诊科,广东惠州516000

出　　处：《临床和实验医学杂志》2017年第4期347-350,共4页Journal of Clinical and Experimental Medicine

基　　金：惠州市科技计划医疗卫生项目(编号:2016Y161)

摘　　要：目的探究骨折合并颅脑外伤患者血清碱性成纤维生长因子(b FGF)、胰岛素样生长因子Ⅰ(IGF-Ⅰ)和信号素3A(SEMA 3A)水平与骨痂形成时间的相关性,为骨折合并颅脑外伤患者加速骨折修复提供理论及临床依据。方法根据是否存在颅脑外伤,分为骨折合并颅脑外伤实验组与单纯骨折对照组,每组60例。采用酶联免疫吸附法(ELISA)检测单纯骨折患者与骨折合并颅脑外伤患者血清b FGF、IGF-Ⅰ及SEMA 3A水平,采用X线检测骨痂形成情况。分析血清b FGF、IGF-Ⅰ及SEMA 3A水平与骨痂形成时间的相关性。分析血清b FGF、IGF-Ⅰ、SEMA 3A水平与反映颅脑外伤程度的GCS评分的相关性。结果与对照组单纯骨折患者相比,实验组骨折合并颅脑外伤患者血清b FGF水平在1周及2周均明显升高(P<0.05),且2周时有上升趋势;实验组IGF-Ⅰ水平及SEMA 3A水平1周时明显升高(P<0.05),2周时有降低的趋势,且与对照组无显著差异,说明血清b-FGF水平在骨折前两周持续升高,而血清中IGF-Ⅰ及SEMA 3A水平在骨折1周时达到高峰;与对照组相比,实验组骨痂形成时间明显缩短(P<0.05),且血清b FGF、IGF-Ⅰ和SEMA 3A水平和骨痂形成时间呈正相关;实验组血清b FGF、IGF-Ⅰ和SEMA 3A水平与GCS评分呈正相关。结论骨折合并颅脑外伤患者血清b FGF、IGF-Ⅰ、SEMA 3A水平与骨痂形成时间呈正相关,血清b FGF、IGF-Ⅰ和SEMA 3A水平与GCS评分呈正相关,说明颅脑外伤程度越高,上述指标分泌越多,从而缩短骨痂形成时间,加速骨折愈合。Objective To explore the correlation of serum levels of b FGF,IGF-Ⅰ,SEMA 3A and the formation of callus in fracture patients with traumatic brain injury,and to provide theoretical and clinical basis for the treatment of traumatic brain injury. Methods According to the existence of craniocerebral trauma,120 cases were divided into fracture and craniocerebral injury group（ experimental group） and simple fracture group（ control group）,60 cases in each group. Enzyme linked immunosorbent adsorption method was used to detect the serum b FGF,IGF-I and SEMA 3A level. The callus formation was detected by X- ray. The correlation of callus formation time and the serum b FGF,IGF-Ⅰ and SEMA 3A level were analyzed. The correlation of GCS scores and the serum b FGF,IGF-Ⅰ and SEMA 3A level were analyzed. Results To compare with the control group,serum b FGF level at 1 weeks and 2 weeks in the experimental group patients were significantly increased（ P〈 0.05）,and it increased in 2 week; the level of IGF-Ⅰ and SEMA 3A levels in experimental group increased significantly at week 1（ P〈0. 05）,and decreased in 2 weeks with no significant difference. The serum b- FGF levels in two weeks continues to rise,while IGF-Ⅰ and SEMA 3A level in the serum got to the peak in the 1 week of fracture; compared with the control group,the callus formation time of the experimental group was significantly shortened（ P〈0. 05）. The serum levels of b FGF,IGF-Ⅰ and SEMA 3A was positively related to the formation time of the callus in the experimental group; the serum levels of b FGF,IGF-Ⅰ and SEMA 3A and GCS score was positively correlated. Conclusion The serum b FGF,IGF-Ⅰ,SEMA 3A level in brain trauma patients were positively related with callus formation time and GCS score,which indicating that the higher degree of craniocerebral trauma is related with their secretion,so as they can shorten the bone callus formation time and accelerate the healing of fracture.

关 键 词：骨折 颅脑外伤 碱性成纤维生长因子 胰岛素样生长因子Ⅰ 信号素3A 骨痂形成时间 

分 类 号：R687.3[医药卫生—骨科学] R651.15[医药卫生—外科学]