血清PGC-1α、VCAM-1、BSAP与创伤性股骨粗隆骨折术后骨折愈合、骨代谢的关系分析  

Analysis of the relationship between serum PGC-1α,VCAM-1,BSAP and postoperative fracture healing of traumatic trochanteric fracture and bone metabolism

作　　者：曲晓勇 朱康[1] 王晓桐[1] 马胡晶 鲍启忠 尹金旺 QU Xiao-yong;ZHU Kang;WANG Xiao-tong(Department of Orthopedics,Beijing Changping District Hospital of Traditional Chinese Medicine,Beijing 102200,China)

机构地区：[1]北京市昌平区中医医院骨科,北京102200

出　　处：《临床和实验医学杂志》2023年第20期2189-2192,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科技计划项目(编号:Z171100001717016)。

摘　　要：目的分析血清过氧化物酶体增殖物激活受体γ共激活因子-lα(PGC-1α)、血管细胞黏附因子-1(VCAM-1)及骨特异性碱性磷酸酶(BSAP)与创伤性股骨粗隆骨折术后骨折愈合、骨代谢的关系。方法回顾性选取2020年10月至2022年10月北京市昌平区中医医院收治的101例创伤性股骨粗隆骨折手术患者作为骨折组,依据术后骨折延迟愈合发生情况将患者分为骨折愈合组(n=98)和骨折愈合延迟组(n=3)。另选取同期收治的98例单纯性骨质疏松患者作为骨质疏松组,选取同期体检的100名健康者作为对照组。比较不同愈合组患者性别构成比、年龄、骨折到入院时间、骨折原因、骨代谢标志物{Ⅰ型前胶原氨基端原肽(PINP)、Ⅰ型胶原羟基端肽β降解产物(β-CTX)、25羟维生素D[25(OH)D]}、PGC-1α、VCAM-1、BSAP水平等资料;采用Logistic回归分析分析影响创伤性股骨粗隆骨折术后骨折愈合的因素;比较3组研究对象的骨代谢标志物水平;采用Pearson分析VCAM-1、PGC-1α、BSAP水平与骨代谢标志物的相关性。结果两组患者性别构成比、年龄、骨折到入院的时间、骨折原因比较,差异均无统计学意义(P>0.05);骨折愈合组PINP、β-CTX、25(OH)D、PGC-1α、BSAP水平均高于骨折愈合延迟组,VCAM-1水平低于骨折愈合延迟组,差异均有统计学意义(P<0.05)。Logistic回归分析结果表明PINP、β-CTX、25(OH)D、PGC-1α、BSAP是创伤性股骨粗隆骨折患者术后骨折延迟愈合的保护因素(P<0.05),VCAM-1是创伤性股骨粗隆骨折患者术后骨折延迟愈合的独立危险因素(P<0.05)。骨折组的PINP、β-CTX水平均高于骨质疏松组和对照组,骨质疏松组的PINP、β-CTX水平均高于对照组,差异均有统计学意义(P<0.05);骨折组的25(OH)D水平显著低于骨质疏松组和对照组,骨质疏松组25(OH)D水平低于对照组,差异均有统计学意义(P<0.05)。PGC-1α、BSAP与PINP均呈负相关(P<0.05),VCAM-1与β-CTX呈正相关(PObjective To analyze the relationship between serum peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α),vascular cell adhesion factor-1(VCAM-1),bone-specific alkaline phosphatase(BSAP)and bone healing and bone metabolism after traumatic trochanteric fracture.Methods A total of 101 surgical patients with traumatic femoral trochanteric fractures admitted to Beijing Changping District Hospital of Traditional Chinese Medicine from October 2020 to October 2022 were retrospectively selected as the fracture group.According to the occurrence of delayed healing of postoperative fractures,the patients were divided into the fracture healing group(n=98)and the delayed fracture healing group(n=3).Another 98 patients with simple osteoporosis admitted during the same period were selected as the osteoporosis group,and 100 healthy individuals who underwent physical examination during the same period were selected as the control group.The gender composition ratio,age,time from fracture to admission,cause of fracture,bone metabolism markers{typeⅠprocollagen amino terminal peptide(PINP),beta c-terminal telopeptide of typeⅠcollagen(β-CTX),25 hydroxyvitamin D[25(OH)D]},PGC-1α,VCAM-1,BSAP levels,and other data of patients in different healing groups were compared.The factors affecting postoperative fracture healing of traumatic femoral trochanteric fractures were analyzed using Logistic regression.The levels of bone metabolism biomarkers in three groups of study subjects were compared.The correlation between PGC-1α,VCAM-1,BSAP levels and bone metabolism markers was analyzed using Pearson correlation.Results There were no statistically significant differences in gender composition ratio,age,time from fracture to admission,and cause of fracture between the two groups of patients(P>0.05);the levels of PINP,β-CTX,25(OH)D,PGC-1α,and BSAP in the fracture healing group were higher than those in the delayed fracture healing group,while the levels of VCAM-1 was lower than that in the delayed fracture healing g

关 键 词：股骨骨折 骨折愈合 血清过氧化物酶体增殖物激活受体γ共激活因子-lα 血管细胞黏附因子-1 骨特异性碱性磷酸酶 创伤性股骨粗隆骨折术后骨折 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]