年龄对老年股骨粗隆间骨折患者骨组织钙、磷及金属微量元素相对含量的影响  

Effect of age on the relative contents of bone calcium,phosphate and metal trace elements in geriatric patients with intertrochanteric fractures

作　　者：林上进[1] 杨丰建[1] 林伟龙[1] 潘依潇 许乐洋[1] 李现龙 范永前[1] LIN Shang jin;YANG Feng jian;LIN Wei long;PAN Yi xiao;XU Yue yang;LI Xian long;FAN Yong qian(Department of Orthopaedics,Huadong Hospital,Fudan University,Shanghai 200040,Chin)

机构地区：[1]复旦大学附属华东医院骨科,上海200040

出　　处：《复旦学报（医学版）》2018年第4期521-525,共5页Fudan University Journal of Medical Sciences

基　　金：上海市卫计委科研课题(140612111756534);上海市科委科研计划项目(15411951500);上海市卫生计生系统重要薄弱学科建设计划(2015ZB0501)~~

摘　　要：目的研究年龄对骨组织不同区域的骨钙、磷及金属微量元素相对含量的影响。方法收集2015年9月至2016年9月在复旦大学附属华东医院骨科接受手术治疗的62例股骨粗隆间骨折老年患者临床资料,并在术中用改进的空心钻头对骨组织的皮质骨与松质骨整体取材,根据年龄将患者分成高龄组(<85岁)和超高龄组(≥85岁)。运用X线聚焦荧光能谱仪检测骨组织皮质骨区域、松质骨区域及交界区域的钙、磷、锰、铁、铜、锌元素含量比重,结合相应患者的血骨代谢指标及髋部骨密度值,比较2组患者骨代谢、骨密度值及骨组织无机元素含量之间的差异性,并分析研究年龄、BMI等与骨组织不同区域无机元素含量的相关性。结果在皮质骨与松质骨交界区域,超高龄组的骨铁含量明显高于高龄组(P=0.018),而骨锰和铜含量较高龄组有所下降。Pearson相关分析结果提示年龄与交界区域的骨铁含量呈显著正相关性(r=0.30,P=0.047),血钙水平与松质骨区域的骨锰和铁元素含量均存在显著负相关性(r=-0.35、-0.39,P=0.020、0.009)。结论骨组织中铁元素可能会随着年龄增长而不断在体内蓄积,而骨铜和锰元素可能会不断丢失。Objective To investigate the effect of age on the relative contents of bone calcium, phosphorus and metal trace elements in geriatric patients with intertrochanteric fractures. Methods From 62 geriatric patients with intertrochanteric fractures accepted surgical treatment in Department of Orthopaedics, Huadong Hospital, a barrel shape bone tissue were harvested during the operation. These patients were to be collected the clinical data and divided into advanced age group （〈85 years） and super age group （≥85 years） from Sep. , 2015 to Sep., 2016. Energy dispersive X-ray fluorescence was used to examine the bone inorganic element contents of calcium, phosphorus, manganese, iron, copper and zinc in cortical bone zone, cancellous bone zone and interfacing zone between cortical bone and cancellous bone. Combination of bone metabolism markers and bone mineral density （BMD） from relevant patients, we compared the differences of bone metabolism, BMD and bone inorganic element contents between super age group and advanced age group, and analyzed the relationship between age, body mass index （BMI） and bone inorganic element contents. Results Bone iron contents were significantly higher in super age group than those in advanced age group （P=0.018） at the interfacing zone between cortical bone and cancellous bone, while bone manganese and copper contents were lower in super age group. The results of Pearson correlation analysis indicated that age had a significantly positive correlation with bone iron contents in interfacing zone （r=0.30, P=0.047）. In addition, the level of serum calcium was negatively correlated with bone manganese and iron contents in the cancellous bone zone （r=-0.35, -0.39, P=0.020, 0.009）. Conclusions The bone iron element may accumulate with age in the body, while copper and manganese element maydecrease in bone tissue.

关 键 词：股骨粗隆间骨折 年龄 金属微量元素 

分 类 号：R683[医药卫生—骨科学]