青壮年胸腰段椎体骨折术后骨丢失和骨代谢及骨密度分析  

Analysis on bone loss and bone metabolism and bone mineral density after thoracolumbar vertebral fracture in young and middle-aged adults

作　　者：王海 王华波 郑泉国 朱银维 张东 翁则福 WANG Hai;WANG Huabo;ZHENG Quanguo;ZHU Yinwei;ZHANG Dong;WENG Zefu(Department of Rehabilitation,Ningbo Yinzhou District Qianhu Hospital,Ningbo,Zhejiang,315000,China)

机构地区：[1]宁波市鄞州区钱湖医院康复科,浙江宁波315000

出　　处：《当代医学》2024年第7期119-122,共4页Contemporary Medicine

基　　金：宁波市医学科技计划项目(2020Y87)。

摘　　要：目的探讨青壮年创伤性脊柱骨折术后长期骨丢失、骨代谢及骨密度情况。方法选取2019年4月至2021年11月宁波市鄞州区钱湖医院收治的33例青壮年胸椎或腰椎椎体骨折(无神经功能缺陷)术后要求取内固定的患者作为实验组,另选取同期本院门诊33名无椎体骨折受试者作为对照组。比较两组临床资料[性别、年龄、体重指数(BMI)、酗酒、吸烟、体育锻炼情况]、生化指标[25-羟维生素D(25-OH-VD)、骨钙素(OC)、β胶原联降解产物(β-CTX)和总Ⅰ型胶原氨基端延长肽(PⅠNP)及血清钙、磷、肌酐]、骨密度。结果两组性别、年龄、BMI、血清钙、血清磷、肌酐、β-CTX、股骨颈骨密度Z值比较差异无统计学意义;实验组酗酒占比、吸烟、体育锻炼占比、25-OH-VD水平、腰椎骨密度Z值低于对照组,PⅠNP、OC水平高于对照组,差异有统计学意义(P<0.05)。结论青壮年创伤性脊柱骨折术后晚期,25-OH-VD水平降低,低腰椎骨密度与骨代谢转换指标不一定相关,高血清PⅠNP也提示更多的骨转换和成骨增加。Objective To investigate long-term bone loss,bone metabolism and bone mineral density in young adults after traumatic spinal frac-ture.Methods 33 cases of young and middle-aged patients with thoracic or lumbar vertebral fractures(without neurological defects)who required internal fixation after surgery from April 2019 to November 2021were selected as the experimental group,and 33 cases of gender and age-matched subjects without vertebral fractures in the outpatient department of our hospital were selected as the control group.Clinical data[sex,age,body mass index(BMI),alcohol abuse,smoking,physical exercise],biochemical parameters[25-hydroxyvitamin D[25-OH-VD],osteocalcin[OC],β-CTX,to-tal typeⅠcollagen amino terminal prolongating peptide[PⅠNP],serum calcium,phosphorus,creatinine]and bone mineral density were compared between the two groups.Results There was no significant difference in gender,age,BMI,serum calcium,serum phosphorus,creatinine,β-CTX and Z value of bone mineral density of femoral neck between the two groups;the proportion of alcohol abuse,smoking,physical exercise,25-OH-VD level and lumbar bone density Z value in the experimental groups were lower than those in the control group,and the levels of PⅠNP and OC were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion 25-OH-VD level is decreased in young adults after traumatic spinal fracture,low lumbar bone density is not necessarily associated with bone metabolic conversion index,high serum PⅠNP also indicates more bone conversion and increased bone formation.

关 键 词：椎体骨折 骨折术后 骨代谢 骨密度 

分 类 号：R687.3[医药卫生—骨科学]