骨肽对老年股骨粗隆间骨折内固定骨代谢的影响  

Effect of ossotide on bone metabolism in elderly undergoing internal fixation for femoral intertrochanteric fractures

作　　者：张洪相[1] 张栋哲 马超[1] 魏金栋[1] 武永东[1] 高乐才[1] ZHANG Hong-xiang;ZHANG Dong-zhe;MA Chao;WEI Jin-dong;WU Yong-dong;GAO Le-cai(The Fourth Orthopedic Department,Integrated Chinese and Western Medicine Hospital,Cangzhou 061000,China;Postgraduate Institute,Tianjin Medical University,Tianjin 300070,China)

机构地区：[1]河北省沧州中西医结合医院创伤骨四科,河北沧州061000 [2]天津医科大学研究生院,天津300070

出　　处：《中国矫形外科杂志》2020年第16期1450-1453,共4页Orthopedic Journal of China

基　　金：沧州市重点研发计划指导项目(编号:183302071)。

摘　　要：[目的]探讨骨肽注射对老年股骨粗隆间骨折内固定患者骨代谢的影响。[方法]老年股骨粗隆间骨折患者120例,随机分为两组。PFNA内固定术后,骨肽组60例给予骨肽注射液静脉滴注1个月,非骨肽组60例未给予骨肽静脉滴注。比较两组血清骨代谢指标、骨密度(BMD)、Harris评分和骨折愈合时间。[结果]治疗后1、6个月,两组患者血清PINP与CTX水平均较治疗前显著下降(P<0.05),骨肽组患者PINP与CTX水平显著低于非骨肽组(P<0.05);治疗后1、6个月,骨肽组BGP、25(OH)D3与BMD均较治疗前显著升高(P<0.05),骨肽组血清25(OH)D3高于非骨肽组(P<0.05)。患者血清PINP、CTX与BMD呈显著负相关(P<0.05);骨肽组Harris评分和骨折愈合时间均优于非骨肽组(P<0.05)。[结论]应用骨肽可改善老年股骨粗隆间骨折内固定患者骨代谢,增加骨密度,从而促进骨折愈合与髋骨功能恢复。[Objective]To explore the effect of ossotide on bone metabolism in the elderly patients who underwent internal fixation for femoral intertrochanteric fractures.[Methods]A total of 120 elderly patients with femoral intertrochanteric fracture were enrolled into this study,and randomly divided into two groups.After open reduction and internal fixation with proximal femoral nail anti-rotation(PFNA),60 patients received ossotide intravenously for a month,while the remaining 60 patients had no ossotide given intravenously.The parameters related to bone metabolism,bone density(BMD),Harris score and fracture healing time were compared between the two groups.[Results]At 1 and 6 months after treatment,the serum PINP and CTX in the two groups significantly decreased compared those before treatment(P<0.05),and the ossotide group had significantly lower PINP and CTX than the non-ossotide group(P<0.05).On other hand,the BGP,25(OH)D3 and BMD in the ossotide group significantly increased(P<0.05),and were significantly higher than the non-ossotide group at 1 and 6 months after treatment(P<0.05).There were significantly negative correlations between BMD and PINP and CTX(P<0.05).The ossotide group proved significantly superior to the non-ossotide group in Harris score at 6 months after treatment and fracture healing time(P<0.05).[Conclusion]The ossotide does improve bone metabolism,increase the bone density,and enhance the fracture healing and recovery of hip function in the elderly with femoral intertrochanteric fractures.

关 键 词：老年股骨粗隆间骨折 股骨近端抗旋转型髓内钉 骨肽 骨代谢 骨密度 

分 类 号：R683.42[医药卫生—骨科学]