老年女性骨质疏松性骨折患者骨代谢相关生化指标变化及分析  

Changes and analysis of biochemical indexes related to bone metabolism in elderly female patients with osteoporosis fractures

作　　者：唐敏[1] 桑阳 赵丹 TANG Min;SANG Yang;ZHAO Dan(Clinical Laboratory Department,Sichuan Provincial Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院检验科,四川成都610041

出　　处：《临床医学研究与实践》2023年第6期17-20,共4页Clinical Research and Practice

基　　金：四川省骨科医院院内课题(No.2019QN01)。

摘　　要：目的探讨老年女性骨质疏松性骨折患者的骨代谢相关生化指标变化情况,并分析血栓形成标志物与骨转换状态的相关性。方法根据是否合并骨折将672例老年女性骨质疏松患者分为非骨折组(212例,骨质疏松未合并骨折)和骨折组(460例,骨质疏松性病理骨折)。收集患者的临床资料和相关血液指标。将非骨折组与骨折组患者按照年龄不同进行分组。比较各组间各指标水平。分析骨折组患者D-二聚体(D-D)与其他骨代谢指标的相关性。比较非骨折组与骨折组年龄校正前、后D-D分布情况。采用单因素及多因素Logistic回归分析探讨影响骨折组年龄校正后D-D水平升高的因素。结果骨折组的白蛋白(ALB)、前白蛋白(PA)、钙(Ca)、磷(P)、25-羟基维生素D[25-(OH)D]水平低于非骨折组,碱性磷酸酶(ALP)、D-D、纤维蛋白降解产物(FDP)、总Ⅰ型胶原氨基端延长肽(TPⅠNP)水平高于非骨折组(P<0.05)。骨折组中,随着年龄增长,患者的ALB、PA、Ca水平降低而D-D、FDP升高(P<0.05)。Spearman相关性分析结果显示,骨折组中,D-D水平与ALB、PA、Ca、25-(OH)D水平呈负相关,与β胶原特殊序列(β-CROSSL)、ALP和TPⅠNP呈正相关(P<0.05)。年龄校正后,骨折组中D-D阴性率从37.39%增长至53.26%。多因素Logistic回归分析结果显示,ALB、PA降低和TPⅠNP升高对年龄校正后D-D阳性结果判断具有显著的独立预测作用(P<0.05)。结论老年女性骨质疏松性骨折患者骨代谢生化指标显著改变并与D-D水平相关,且ALB、TPⅠNP与年龄校正后D-D水平独立相关,提示积极监测骨转换状态、提高营养状态和维持稳定的抗骨质疏松治疗对老年女性骨质疏松性骨折并发血栓风险有一定的预防意义。Objective To investigate the changes of biochemical indexes related to bone metabolism in elderly female patients with osteoporotic fractures,and to analyze the correlation between thrombosis markers and bone turnover status.Methods According to whether there were fractures,672 elderly female patients with osteoporosis were divided into nonfracture group(212 cases,osteoporosis without fracture)and fracture group(460 cases,osteoporotic pathological fracture).The clinical data and related blood indexes of the patients were collected.The patients in the non-fracture group and the fracture group were grouped according to age.The levels of each index between groups were compared.The correlation between D-dimer(D-D)and other bone metabolism indexes in the fracture group was analyzed.The D-D distribution before and after age correction was compared between the non-fracture group and the fracture group.The factors affecting the increase of D-D level after age correction in the fracture group were explored by univariate and multivariate Logistic regression analysis.Results The levels of albumin(ALB),prealbumin(PA),calcium(Ca),phosphorus(P)and 25-hydroxyvitamin D[25-(OH)D]in the fracture group were lower than those in the non-fracture group,and the levels of alkaline phosphatase(ALP),D-D,fibrin degradation products(FDP)and total procollagen type I N-terminal propeptide(TPⅠNP)were higher than those in the non-fracture group(P<0.05).In the fracture group,the levels of ALB,PA and Ca decreased while the levels of D-D and FDP increased with age(P<0.05).The Spearman correlation analysis results showed that in the fracture group,D-D level was negatively correlated with ALB,PA,Ca and 25-(OH)D level,and positively correlated withβ-special sequence(β-CROSSL),ALP and TPⅠNP(P<0.05).After age correction,the D-D negative rate in the fracture group increased from 37.39%to 53.26%.The multivariate Logistic regression analysis results showed that the decrease of ALB,PA and the increase of TPⅠNP had significant independent predictive

关 键 词：骨代谢生化指标 老年女性 骨质疏松性骨折 年龄校正的D-二聚体 

分 类 号：R580[医药卫生—内分泌] R683[医药卫生—内科学]