肌源性微粒及lactadherin蛋白与髋关节周围骨折患者高凝状态的相关研究  

Correlation of muscle-derived microparticles and lactadherin proteins with hypercoagulability in patients with perihip fractures

作　　者：万鑫 徐春磊 石巍 蒋招会 李稚君[1] 张华峰[1] 李晖[1] Wan Xin;Xu Chunlei;Shi Wei;Jiang Zhaohui;Li Zhijun;Zhang Huafeng;Li Hui(Department of Orthopaedics,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院骨科,天津300050

出　　处：《中华骨科杂志》2022年第13期839-846,共8页Chinese Journal of Orthopaedics

摘　　要：目的通过流式细胞技术及凝血及血小板功能分析仪, 研究骨骼肌源性微粒(skeletal muscle derived microparticles, SKMPs)及其清除蛋白Lactadherin在髋关节周围骨折患者外周血的变化水平及其凝血功能的影响。方法收集2020年10月至2021年1月共44例年龄(72.87±13.9)岁的髋关节周围骨折患者为骨折组, 同时期40例健康人群为无骨折组;应用凝血与血小板功能分析仪测定骨折组和无骨折组的凝血酶生成时间(activated clotting time, ACT)评估高凝状态;应用流式细胞仪测定研究对象外周静脉血中SKMPs水平;应用ELISA法检测骨折组、无骨折组外周血中MPs清除蛋白lactadherin水平在各组间的差异。结果 44例髋关节周围骨折患者中股骨颈骨折33例(75%), 转子间骨折11例(25%)。髋关节周围骨折组外周血中SKMPs浓度:175.73个/μl;骨折术后组124.28个/μl;无骨折组90.69个/μl。髋关节周围骨折组ACT为(377.5±76.2)s, 骨折术后组ACT为(498.1±97.1)s, 无骨折组ACT为(505.7±44.0)s;通过相关性分析发现骨折患者SKMPs计数与ACT值间存在线性关系(r=-0.52, P<0.001);骨折术后组外周静脉血中SKMPs浓度与ACT值之间无明显相关性(P>0.05);髋关节周围骨折组lactadherin蛋白浓度:2 779.61 pg/ml;骨折术后组1 985.38 pg/ml;无骨折组1 651.19 pg/ml。Lactadherin浓度与SKMPs浓度之间存在正相关, 相关系数为0.70。结论 SKMPs在髋关节周围骨折患者的高凝状态起到一定作用;lactadherin的失代偿可能是造成髋关节骨折患者围术期高凝状态的原因。Objective To investigate the changes of skeletal muscle-derived microparticles(SKMPs)and their scaving proteins lactadherin in peripheral blood of patients with perihip fractures and their effects on blood coagulation.It provides a theoretical basis for clinical evaluation of hypercoagulability in patients with perioperative hip fractures.Methods A total of 44 patients(72.87±13.9 years old)with perihip fractures from October 2020 to January 2021 were included in the fracture group,and 40 healthy people were included in the group without fracture.Activated clotting time(ACT)in fracture group and control group was measured by coagulation and platelet function analyzer.The level of SKMPs in peripheral venous blood was determined by flow cytometry.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of MPs scaving proteins lactadherin in peripheral blood of fracture group and control group.Results A total of 44 patients with perihip fractures were included.There were 33(75%)femoral neck fractures and 11(25%)intertrochanteric fractures.SKMPs concentration in peripheral blood of perihip fracture group 175.73/μl;postoperative fracture group 124.28/μl;Normal control group 90.69/μl.ACT was(377.5±76.2)s in the perihip fracture group,(498.1±97.1)s in the post-fracture group,and(505.7±44.0)s in the control group.Correlation analysis showed that there was a linear relationship between SKMPs count and ACT value in fracture patients(r=-0.52,P<0.001).There was no significant correlation between SKMPs concentration and ACT value in peripheral venous blood of the post-fracture group(P>0.05);Lactadherin protein concentration in perihip fracture group:2779.61 pg/ml;Fracture postoperative group 1985.38 pg/ml;Normal control group 1651.19 pg/ml.There is a positive correlation between Lactadherin concentration and SKMPs concentration with a correlation coefficient of 0.70.Conclusion SKMPs plays a role in the hypercoagulability of patients with perihip fractures.Decompensation of lactadherin protein may be one of

关 键 词：髋骨折 微粒体 血液凝固 对比研究 

分 类 号：R683[医药卫生—骨科学]