骨折患者初期血清钙磷浓度变化与骨折部位的相关性分析  

Analysis of the Correlation between Serum Calcium and Phosphorus Concentration Changes and Fracture Site in Early Fracture Patients

作　　者：池继敏 张静[1] 邹明[1] 程松苗 李敏[3] 刘小莉[1] CHI Jimin;ZHANG Jing;ZOU Ming;CHENG Songmiao;LI Min;LIU Xiaoli(Department of Clinical Laboratory,Sichuan Province Orthopedic Hospital,Chengdu 610041,China;Department of Knee Joint Sports Injury,Sichuan Province Orthopedic Hospital,Chengdu 610041,China;Department of Rheumatology and Osteoarthrology,Sichuan Province Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院检验科,成都610041 [2]四川省骨科医院膝关节运动损伤科,成都610041 [3]四川省骨科医院风湿骨关节病科,成都610041

出　　处：《现代检验医学杂志》2024年第6期218-222,共5页Journal of Modern Laboratory Medicine

基　　金：成都市卫生健康委员会科研项目(编号:2022447)。

摘　　要：目的探究骨折患者初期血钙、血磷、钙磷乘积水平变化并分析其与骨折部位的相关性。方法选取2021年1月~2023年11月四川省骨科医院收治的骨折患者1049例作为研究对象,按骨折部位粗分为两组:上半身部位骨折(n=478)和下半身部位骨折(n=571);细分十组:椎体骨折(n=108)、锁骨骨折(n=109)、上肢骨折(n=106)、手部骨折(n=104)、股骨颈骨折(n=103)、股骨粗隆间骨折(n=106)、髌骨骨折(n=101)、下肢骨折(n=103)、足部骨折(n=105)和其他骨折(n=104)。另选取同期健康体检人群110例作为对照组。全部患者于急诊当日和入院后24~48h两次抽取静脉血测定血钙、血磷,并计算钙磷乘积,比较三者水平变化并分析其与骨折部位的相关性。结果与对照组比较,骨折患者急诊当日和入院后24~48h,血钙(2.27±0.12 mmol/L,2.19±0.12 mmol/L vs2.35±0.10mmol/L)、血磷(1.00±0.20mmol/L,1.08±0.19mmol/L vs 1.15±0.15mmol/L)、钙磷乘积(28.10±6.00mg/dl,29.30±5.85mg/dl vs 33.41±4.87mg/dl)均降低,差异具有统计学意义(t=6.804,12.501;7.475,3.722;8.964,7.115,均P<0.01)。上、下半身骨折相比,急诊当日血钙、血磷和钙磷乘积下半身骨折低于上半身骨折(t=4.129,5.931,6.660,均P<0.01);入院后24~48h则仅钙、钙磷乘积下半身骨折低于上半身骨折(t=6.432,1.990,均P<0.05),差异具有统计学意义。沿时间轴比较,入院后24~48h与急诊当日相比,上、下半身骨折均表现出血钙降低而血磷升高(t=12.779,-5.730;16.919,-14.358),钙磷乘积则仅下半身骨折较急诊当日升高(t=-8.860),差异具有统计学意义(均P<0.01)。不同部位骨折患者入院后24~48h与急诊当日相比,除椎体骨折外,其余九组血钙均降低(t=6.233~11.349);除上肢骨折、手部骨折外,其余八组血磷升高(t=-7.770~-3.327);椎体骨折、股骨颈骨折、股骨粗隆间骨折、下肢骨折、足部骨折、其他骨折钙磷乘积升高(t=-5.819~-2.927),差异具有统计学意义(均P<0.01)。结论�Objective To explore the changes in early serum calcium,serum phosphorus,and calcium-phosphorus product levels in patients with fractures and analyze their correlation with the fracture site.Methods 1049 patients with fractures admitted to Sichuan Province Orthopedic Hospital from January 2021 to November 2023 were selected as the research subjects.According to the fracture location,they were roughly divided into two groups:upper body fracture(n=478)and lower body fracture(n=571).Carefully divided into ten groups:vertebral fracture(n=108),clavicle fracture(n=109),upper limb fracture(n=106),hand fracture(n=104),femoral neck fracture(n=103),femoral intertrochanteric fracture(n=106),patella fracture(n=101),lower limb fracture(n=103),foot fracture(n=105)and other fractures(n=104).Another 110 cases of healthy physical examination people during the same period were selected as the control group.Venous blood was drawn from all patients twice on the day of emergency within 24 to 48 hours after admission,serum calcium and serum phosphorus were measured,and the calcium-phosphorus product was calculated.Compare the changes in the levels of the three and analyzed their correlation with the fracture site.Results Compared with the control group,the serum calcium(2.27±0.12 mmol/L,2.19±0.12 mmol/L vs 2.35±0.10mmol/L),serum phosphorus(1.00±0.20mmol/L,1.08±0.19mmol/L vs 1.15±0.15mmol/L),and calcium-phosphorus product(28.10±6.00mg/dl,29.30±5.85mg/dl vs 33.41±4.87mg/dl)of fracture patients were all reduced on the day of emergency and 24 to 48 hours after admission,and the differences were statistically significant(t=6.804,12.501;7.475,3.722;8.964,7.115,all P<0.01).Comparing upper and lower body fractures,serum calcium,serum phosphorus,and calcium-phosphorus product on the emergency day was lower in lower body fracture than in upper body fracture(t=4.129,5.931,6.660,all P<0.01),24 to 48 hours after admission,only the serum calcium and calcium-phosphorus product were lower in lower body fracture than in upper body fracture(t=

关 键 词：骨折 血钙 血磷 钙磷乘积 

分 类 号：R683[医药卫生—骨科学] R446.111[医药卫生—外科学]