老年男性股骨转子间骨折患者围术期血清IL-6水平变化研究  

Perioperative changes of serum interleukin 6 levels in elderly male patients with intertrochanteric fracture

作　　者：陈翔溆 朱桓毅 吴伟 田楚伟[1,2,3,4] 石柳 范文斌[1,2,3,4] 张程[1,2,3,4] 李荥娟 陈辉 高伟[3,4,5] 芮云峰[1,2,3,4] CHEN Xiangxu;ZHU Huanyi;WU Wei;TIAN Chuwei;SHI Liu;FAN Wenbin;ZHANG Cheng;LI Yingjuan;CHEN Hui;GAO Wei;RUI Yunfeng(Trauma Center,Department of Orthopaedic Surgery,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu,210009,P.R.China;Institute of Trauma Orthopaedics,Southeast University,Nanjing Jiangsu,210009,P.R.China;Multidisciplinary Team for Geriatric Hip Fracture,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu,210009,P.R.China;School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Department of Geriatrics,Zhongda Hospital Affiliated to Southeast University,Nanjing Jiangsu,210009,P.R.China)

机构地区：[1]东南大学附属中大医院创伤骨科、创伤救治中心,南京210009 [2]东南大学创伤骨科研究所,南京210009 [3]东南大学附属中大医院老年髋部骨折多学科综合诊疗协作组(MDT),南京210009 [4]东南大学医学院,南京210009 [5]东南大学附属中大医院老年科,南京210009

出　　处：《中国修复重建外科杂志》2024年第10期1249-1253,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨老年男性股骨转子间骨折患者围术期血清IL-6水平变化,为此类患者的炎症控制提供依据。方法回顾分析2021年1月-2022年12月收治且符合选择标准的40例年龄≥60岁男性股骨转子间骨折患者临床资料,其中25例为非骨质疏松症患者(T值>−2.5,A组),15例为骨质疏松症患者(T值≤−2.5,B组);另外根据年龄配比规则纳入40例年龄≥60岁健康男性作为对照(C组)。3组受试者年龄、吸烟史、饮酒史、身体质量指数、合并症(高血压病和糖尿病)、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血尿素氮、肌酐和总蛋白等基线资料比较,差异均无统计学意义(P>0.05)。取C组受试者血清样本,A、B组患者术前及术后1、3、5、7 d的血清样本,ELISA法检测血清IL-6水平;采用Pearson相关分析A、B组所有患者围术期各时间点IL-6水平与T值的相关性。记录A、B组患者术后住院期间并发症发生情况和1年死亡率。结果A、B组术前IL-6水平显著高于C组,B组显著高于A组,差异均有统计学意义(P<0.05)。A、B组患者术后1 d IL-6水平较术前显著升高,然后呈逐渐下降趋势,至术后7 d时降至接近术前水平;术后各时间点B组IL-6水平均显著高于A组,差异有统计学意义(P<0.05)。相关性分析示,A、B组所有患者围术期各时间点IL-6水平与T值均成负相关(P<0.05)。术后住院期间A组4例患者(16.0%)发生并发症,包括肺部感染2例、尿路感染1例、心力衰竭1例;B组3例患者(20.0%)发生并发症,包括肺部感染2例、消化道出血1例;两组并发症发生率比较差异无统计学意义(χ^(2)=0.104,P=0.747)。A、B组分别有2例(8.0%)和4例(26.7%)于术后1年内死亡,两组死亡率比较差异无统计学意义(χ^(2)=2.562,P=0.109)。结论老年男性股骨转子间骨折患者术后早期血清IL-6水平显著增高,尤其在骨质疏松症患者中更为明显。围术期监测炎症状态并及时控制炎症反应,可降低并�Objective To investigate the perioperative changes in serum interleukin 6(IL-6)levels in elderly male patients with intertrochanteric fractures,and provide evidence for inflammatory control in this patient population.Methods The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed,including 25 non-osteoporosis patients(T value>−2.5,group A)and 15 osteoporosis patients(T value≤−2.5,group B).In addition,40 healthy men aged more than 60 years old were included as controls(group C)according to the age matching rule.There was no significant difference in age,smoking history,drinking history,body mass index,complications(hypertension and diabetes),alanine aminotransferase,aspartate aminotransferase,blood urea nitrogen,creatinine,and total protein among the 3 groups(P>0.05).Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1,3,5,and 7.IL-6 levels were measured using ELISA assay.Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B.Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B.Results Preoperative IL-6 levels were significantly higher in groups A and B than in group C(P<0.05),with group B being significantly higher than group A(P<0.05).In groups A and B,IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased,approaching preoperative levels by postoperative day 7.IL-6 levels in group B were significantly higher than those in group A at all postoperative time points(P<0.05).Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B(P<0.05).Complications occurred in 4 patients(16.0%)in group A,including 2

关 键 词：骨质疏松症 男性 股骨转子间骨折 骨折愈合 IL-6 老年 

分 类 号：R687.3[医药卫生—骨科学]