术前血清IL-2R、IL-6和IL-8水平与老年髋关节骨折术后30 d预后的相关性  

Association between serum IL-2R,IL-6 and IL-8 before treatment and postoperative 30 d prognosis of hip joint fracture in elderly patients

作　　者：洪伟祥 宋云霄[2] 贾玖德 张文通 沈文晖 黄晋旺 张雷 米尔萨力江·亚森 张银网[3] HONG Weixiang;SONG Yunxiao;JIA Jiude;ZHANG Wentong;SHEN Wenhui;HUANG Jinwang;ZHANG Lei;SARI Jiang Yassen;ZHANG Yinwang(Department of Orthopaedics,Xiamen Hospital,Zhongshan Hospital,Fudan University,Xiamen 361015,Fujian,China;Department of Clinical Laboratory,Shanghai Xuhui Central Hospital,Shanghai 200031,China;Department of Orthopaedics,Shanghai Xuhui Central Hospital,Shanghai 200031,China)

机构地区：[1]复旦大学附属中山医院厦门医院骨科,福建厦门361015 [2]上海市徐汇区中心医院检验科,上海200031 [3]上海市徐汇区中心医院骨科,上海200031

出　　处：《检验医学》2021年第11期1159-1163,共5页Laboratory Medicine

摘　　要：目的探讨术前白细胞介素2受体(IL-2R)、白细胞介素(IL)6、IL-8和IL-10水平与老年髋关节骨折患者术后30 d预后的关系。方法选取老年髋关节骨折患者179例,检测其术前血清IL-2R、IL-6、IL-8和IL-10水平,并进行30 d的随访。采用Kaplan-Meier生存曲线及Log-rank检验分析老年髋关节骨折患者术后30 d的生存率。采用Cox回归分析评估老年髋关节骨折患者术后30 d死亡的危险因素。结果179例老年髋关节骨折患者术后30 d内有18例死亡,死亡率为10.06%。死亡组IL-2R、IL-6和IL-8水平显著高于存活组(P<0.05)。IL-10水平2个组之间差异无统计学意义(P>0.05)。多因素Cox回归分析结果显示,治疗前IL-2R升高、IL-6升高和IL-8升高均为老年髋关节骨折患者30 d死亡的危险因素[比值比(OR)值分别为1.020、1.008、1.004,95%可信区间(CI)分别为1.010~1.031、1.002~1.015、1.000~1.007,P<0.001]。根据老年髋关节骨折患者术前血清IL-2R、IL-6和IL-8水平的中位数值分别分组,Kaplan-Meier生存曲线分析结果显示,高IL-2R组、高IL-6组和高IL-8组术后30 d生存率分别低于低IL-2R组、低IL-6组和低IL-8组(Log-rankχ2值分别为7.54、6.03、8.22,P<0.05)。结论术前高IL-2R、IL-6和IL-8水平的老年髋关节骨折患者预后较差。IL-2R、IL-6和IL-8或可作为老年髋关节骨折患者术后评估的指标。Objective To investigate the correlation between the level of interleukin 2 receptor(IL-2 R),interleukin(IL)-6,IL-8 and IL-10 before treatment and the postoperative 30 d prognosis after hip joint fracture in elderly patients.Methods A total of 179 elderly patients with hip joint fracture were enrolled,and the preoperative levels of serum IL-2 R,IL-6,IL-8 and IL-10 were determined and followed up for 30 d.Kaplan-Meier curve and Log-rank test were used to analyze the survival rate of elderly patients with hip joint fracture at postoperative 30 d.Cox regression analysis was used to evaluate the risk factors of death for 30 d after hip joint fracture.Results Among the 179 elderly patients with hip joint fracture,18 died during the 30 d after operation,the mortality rate was 10.06%.The levels of IL-2 R,IL-6 and IL-8 in death group were higher than those in survival group(P<0.05).There was no statistical significance in IL-10 level between the 2 groups(P>0.05).Multivariate Cox regression analysis showed that the increase of IL-2 R,IL-6 and IL-8 before operation were risk factors for 30 d death in elderly patients with hip joint fracture[odds ratios(OR)were 1.020,1.008 and 1.004,95%confidence intervals(CI)were 1.010-1.031,1.002-1.015 and 1.000-1.007,respectively,P<0.001].According to the medians of preoperative serum IL-2 R,IL-6 and IL-8 levels of elderly patients with hip joint fracture,Kaplan-Meier survival curve analysis results showed that the 30 d survival rates of high IL-2 R,high IL-6 and high IL-8 groups were lower than those of low IL-2 R,low IL-6 and low IL-8 groups(Log-rankχ2=7.54,6.03 and 8.22,P<0.05).Conclusions The levels of IL-2 R,IL-6 and IL-8 before operation can be used as indicators of postoperative evaluation,and the prognosis of elderly hip joint fracture patients with high preoperative levels of IL-2 R,IL-6 and IL-8 is poor.

关 键 词：白细胞介素2受体 白细胞介素6 白细胞介素8 白细胞介素10 髋关节骨折 老年人 

分 类 号：R446.1[医药卫生—诊断学]