血清骨保护素在老年人工髋关节置换患者中的表达及疗效影响因素分析  

Level of Serum Osteoprotegerin in Older Patients with Artificial Hip Replacement and Factors Affecting the Outcome of Patients

作　　者：汤勇 曾昭池 朱志勇 袁永端 余明阳 Tang Yong;Zeng Zhaochi;Zhu Zhiyong;Yuan Yongduan;Yu Mingyang(Department of Orthopedics,the 922nd Hospital of the Joint Service Support Force of the PLA,Hengyang 421002)

机构地区：[1]解放军联勤保障部队第922医院骨科,衡阳421002

出　　处：《国际老年医学杂志》2023年第2期159-162,共4页International Journal of Geriatrics

基　　金：湖南省卫健委科研计划项目(C2015-29)。

摘　　要：目的探究血清骨保护素(OPG)在老年人工髋关节置换患者中的临床意义及疗效的影响因素分析。方法选取2017年4月~2018年3月解放军联勤保障部队第922医院进行单侧全髋关节置换的84例股骨颈骨折老年患者作为观察组,另收集80例同期在本院进行体检的正常人群作为对照组。采用ELISA法检测患者术前及术后1周血清中OPG的表达情况;采用人工全髋关节疗效评分对患者术后临床疗效进行评估;根据观察组患者术后临床疗效再将其分为良好组(优秀+良好)与不良组(一般+较差),比较两组患者治疗前OPG的表达,并根据其表达绘制ROC曲线,采用二元多因素logistic回归分析影响患者临床疗效的危险因素。结果术前观察组血清中OPG表达量高于对照组(P<0.05),观察组术后1周血清中OPG表达水平低于术前(P<0.05)。观察组术后临床疗效评估显示,优秀24例,良好33例,一般18例,较差9例;不同疗效患者之间术前血清OPG表达比较,差异有统计学意义(P<0.05),且疗效越差,术前血清OPG表达水平越高。良好组术前OPG表达水平低于不良组(P<0.05);OPG预测疗效的ROC曲线下面积为0.778(95%CI:0.673~0.884);多因素logistic回归分析显示,术前OPG水平是影响疗效的独立危险因素(P<0.05)。结论OPG在老年髋关节置换患者术前术后存在差异表达,疗效越差的患者术前血清中OPG水平越高,术前OPG水平是老年髋关节置换患者临床疗效的独立危险因素。Objective To investigate the clinical significance of serum osteoprotegerin(OPG)in older patients with hip arthroplasty and analyze the influential factors of efficacy.Methods A total of 84 older patients with femoral neck fracture who underwent unilateral total hip replacement from April 2017 to March 2018 were collected as the observation group,and 80 individuals who underwent health check-up at the same time were collected as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to measure the expression of OPG in serum before and 1 week after operation.Harris hip score was used to evaluate the outcome of patients after operation.The patients in the observation group were divided into a good outcome group(excellent and good)and a poor outcome group(fair and poor)according to the clinical efficacy after operation.The preoperative OPG level was compared between the two groups,and receiver operating characteristic(ROC)curve was constructed according to OPG level.Binary multivariate logistic regression was used to analyze the factors affecting the efficacy.Results The OPG level in the observation group was higher than that in the control group before operation(P<0.05),and that was lower at 1 week after operation than before operation in the observation group(P<0.05).The outcomes were excellent in 24 cases,good in 33,fair in 18,and poor in 9.There was a statistically significant difference in preoperative OPG level between the patients with different therapeutic effects(P<0.05),and the worse the therapeutic effect,the higher the preoperative OPG level.The OPG level in the good outcome group was lower than that in the poor outcome group(P<0.05).The area under the ROC curve of OPG in predicting the efficacy was 0.778(95 CI%:0.673-0.884).Multivariate logistic regression analysis showed that preoperative OPG level was an independent risk factor affecting the efficacy.Conclusion There is a difference in the expression level of OPG in older patients with hip replacement before and after operation.The patient

关 键 词：骨保护素 髋关节置换 危险因素 

分 类 号：R687.4[医药卫生—骨科学]