骨质疏松性椎体压缩性骨折患者血清N-MID和尿液DPD水平与椎体愈合程度的相关性研究  

Correlation between the Levels of Serum N-MID,Urine DPD and the Degree of Vertebral Union in Osteoporotic Vertebral Compression Fracture

作　　者：朱超 茹平 罗文强 ZHU Chao;RU Ping;LUO Wen-qiang(Third Department of Orthopedics,Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Shaanxi Xianyang 712000,China;Department of Laboratory Medicine,the Eighth Hospital of Xi’an,Xi’an 710061,China;Department of Clinical Laboratory,the Central Hospital of Xianyang,Shaanxi Xianyang 712000,China)

机构地区：[1]陕西中医药大学附属医院骨三科,陕西咸阳712000 [2]西安市第八医院检验科,西安710061 [3]咸阳市中心医院检验科,陕西咸阳712000

出　　处：《现代检验医学杂志》2020年第4期130-133,共4页Journal of Modern Laboratory Medicine

摘　　要：目的探讨血清骨钙素N端中分子片段(N-terminal middle molecular fragment of osteocalcin,N-MID)和尿液脱氧吡啶酚(deoxy pyridinoline,DPD)水平与骨质疏松性椎体压缩性骨折(osteoporotic vertebral compressibility fracture,OVCF)患者椎体愈合程度的相关性。方法收集2015年1月~2019年1月期间在陕西中医药大学附属医院接受经皮椎体成形术(percutaneousvertebroplasty,PVP)治疗的250例OVCF患者的临床资料进行回顾性分析。依据PVP术后患者椎体愈合状况分为愈合组(230例)和延迟组(20例)。尿液DPD和血清N-MID水平采用酶联免疫吸附法检测;采用双能X线骨密度仪检测患者的骨密度(bone mineral density,BMD)值,同时测定两组患者术后12周的视觉模拟(visual analogue scale,VAS)评分,伤椎高度恢复率与后凸畸形角(cobb angle,Cobb角),比较分析以上指标的变化与OVCF术后椎体愈合程度相关性。结果在愈合组和延迟组中,血清N-M ID(ng/ml)和尿液DDP(nmol/ml)水平分别为45.21±9.76,28.25±6.71和423.96±37.28,623.62±51.20。与愈合组比较,延迟组的DPD水平均明显增高,而N-M ID水平则明显降低(t=36.18~53.16),均P=000。在愈合组和延迟组中,Cobb角(°),BMD值,伤椎高度恢复率(%)及VAS评分(分)分别为10.05±1.97 vs 15.23±2.26;-2.69±0.12 vs-3.17±0.15;57.21±6.92 vs 67.89±8.23;2.59±0.46 vs 3.35±0.53,与愈合组比较,延迟组的Cobb角、伤椎高度恢复率及VAS评分均明显增高,而术前BMD水平则明显降低(t=26.35~89.29,均P=000)。相关性分析显示,在延迟组和愈合组中,DPD和N-MID水平具有负相关性(r=-0.813,-0.792,P均<0.01)。在延迟组和愈合组中,DPD分别与Cobb角、伤椎高度恢复率及VAS评分有正相关性,而与BMD值有负相关性(r延迟组=0.819,0.829,0.806,-0.799,均P<0.01;r愈合组=0.783,0.813,0.795,-0.767,均P<0.01)。在延迟组和愈合组中,N-M ID分别与Cobb角、伤椎高度恢复率及VAS评分有负相关性,而与BMD值有正相关性(r延迟组=-0.833,-0.852,-0.821Objective To investigate the correlation between the levels of serum N-terminal molecular fragment of osteocalcin(N-MID)and urinary deoxy pyridinoline(DPD)and the degree of vertebral union for the patients with osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of 250 OVCF patients who were treated with PVP in the Affiliated Hospital of Traditional Chinese Medicine University of Shaanxi from January 2016 to January 2019 were analyzed retrospectively.According to the condition of vertebral union after PVP,the patients were divided into two groups:healing group(230 cases)and delayed group(20 cases).The levels of urine DPD and serum N-MID were detected by enzyme-linked immunosorbent assay and bone mineral density(BMD)was detected by dual energy X-ray bone densitometer.The visual analogue score(VAS score),recovery rate of injured vertebra height and Cobb angle were measured at 12 weeks after operation.The correlation between the changes of the above indexes and the degree of vertebral union of OVCF was analyzed.Results The levels of serum N-MID(ng/ml)and urine DDP(nmol/ml)were 45.21±9.76 and 28.25±6.71,423.96±37.28 and 623.62±51.20 in the healing group and the delayed group,respectively.Compared with the healing group,the DPD level in the delayed group was significantly higher,while the N-MID level was significantly lower(t=36.18~53.16,P=000).In the healing group and the delayed group,the Cobb angle(°),BMD values,the recovery rate(%),the recovery rate of the injured vertebra height and VAS score(point)in the delayed group were 10.05±1.97 vs 15.23±2.26;-2.69±0.12 vs-3.17±0.15;57.21±6.92 vs 67.89±8.23;2.59±0.46 vs 3.35±0.53,respectively.Compared with the healing group,the Cobb angle,the recovery rate of the injured vertebra height and VAS score in the delayed group were significantly higher,while the preoperative BMD level was significantly lower(t=26.35~89.29,all P=0.000).The correlation analysis showed that the levels of DPD and N-MID were negatively correlated(r=-0.813,-0.792,al

关 键 词：骨质疏松性椎体压缩性骨折 椎体愈合 椎体延迟愈合 骨密度 骨钙素N端中分子片段 脱氧吡啶酚 

分 类 号：R683[医药卫生—骨科学] R446.11[医药卫生—外科学]