老年患者脊柱骨质疏松性压缩骨折的骨代谢相关危险因素分析  

Analysis of risk factors related to bone metabolism in elderly patients with osteoporotic vertebral compression fracture

作　　者：霍青 乔梁 李华 王云清 黄凯 HUO Qing;QIAO Liang;LI Hua;WANG Yunqing;HUANG Kai(Department of Clinical Laboratory,the Second Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221006,China;Department of Spine Surgery,the Second Affiliated Hospital of Xuzhou Medical University,Jiangsu Province,Xuzhou221006,China)

机构地区：[1]徐州医科大学第二附属医院检验科,江苏徐州221006 [2]徐州医科大学第二附属医院脊柱外科,江苏徐州221006

出　　处：《中国当代医药》2023年第28期125-128,134,共5页China Modern Medicine

基　　金：江苏省老年健康科研项目(LK2021038);江苏省徐州市科技项目(KC22204)。

摘　　要：目的探讨骨代谢标志物对老年患者脊柱骨质疏松性压缩骨折(OVCF)的风险预测价值。方法选取2022年1月至8月徐州医科大学第二附属医院脊柱外科收治的133例OVCF患者为研究组,180例原发性骨质疏松症患者为对照组。比较两组患者的性别、年龄、高血压、糖尿病、吸烟史、血清甲状旁腺激素(PTH)、25-羟维生素D[25-(OH)D]、降钙素(CT)、β-胶原特殊序列(β-CTX)及1型前胶原氨基端延长肽(P1NP)、钙、磷,采用多因素logistic回归模型分析25-(OH)D、CT、β-CTX及P1NP的影响因素。结果两组患者的性别、年龄、高血压、糖尿病、吸烟史、PTH、钙、磷比较,差异无统计学意义(P>0.05)。单因素分析结果显示,25-(OH)D、CT、β-CTX及P1NP与OVCF有关,差异有统计学意义(P<0.001)。多因素logistic回归分析显示,β-CTX(β=0.325,OR=1.750,95%CI:1.532~1.999)及P1NP(β=0.023,OR=2.271,95%CI:2.245~2.299)是OVCF的独立危险因素(P<0.001)。17例患者在3个月内再发OVCF,单因素分析结果显示,β-CTX及P1NP与短期内再发OVCF有关,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,β-CTX(β=2.840,OR=1.306,95%CI:1.248~1.364)是短期内再发骨折的独立危险因素(P<0.05)。结论β-CTX和P1NP是OVCF的独立危险因素,β-CTX、P1NP升高的患者,存在较高的OVCF发生风险。β-CTX是短期内再发骨折的独立危险因素,OVCF患者体内高水平的β-CTX预示着其短期内易再发骨质疏松性骨折。Objective To investigate the value of bone metabolism in predicting the risk of osteoporotic vertebral compression fracture(OVCF)in elderly patients.Methods A total of 133 patients with OVCF admitted to Department of Orthopaedics of the Second Affiliated Hospital of Xuzhou Medical University from January to August 2022 were selected as the study group and 180 patients with primary osteoporosis as the control group.Gender,age,hypertension,diabetes,smoking history,serum parathyroid hormone(PTH),25-hydroxyvitamin D[25-(OH)D],calcitonin(CT),beta-crosslaps(β-CTX),propeptide of type I procollagen(P1NP),calcium and phosphorus were compared between the two groups.Multivariate logistic regression model was used to analyze the influencing factors of 25-(OH)D,CT,β-CTX and P1NP.Results There were no significant differences in gender,age,hypertension,diabetes,smoking history,PTH,calcium and phosphorus between the two groups(P>0.05).Univariate analysis showed that 25-(OH)D,CT,β-CTX and P1NP were associated with OVCF,and the differences were statistically significant(P<0.001).Multivariate logistic regression analysis showed thatβ-CTX(β=0.325,OR=1.750,95%CI:1.532-1.999)and P1NP(β=0.023,OR=2.271,95%CI:2.245-2.299)were independent risk factors for OVCF(P<0.001).OVCF recurred in 17 patients within 3 months.Univariate analysis showed thatβ-CTX and P1NP were associated with short-term recurrence of OVCF,the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed thatβ-CTX(β=2.840,OR=1.306,95%CI:1.248-1.364)was an independent risk factor for recurrent fractures in the short term(P<0.05).Conclusionβ-CTX and P1NP are independent risk factors for OVCF,and patients with elevatedβ-CTX and P1NP have a higher risk of OVCF.β-CTX is an independent risk factor for recurrent fractures in the short term,and high level ofβ-CTX in patients with OVCF indicate a short-term susceptibility to recurrent osteoporotic fractures.

关 键 词：骨质疏松性脊柱压缩骨折 骨代谢标记物 β-胶原特殊序列 1型前胶原氨基端延长肽 

分 类 号：R687.3[医药卫生—骨科学]