血清CTRP3 BGLAP及sCD44水平与创伤性股骨粗隆间骨折患者PFNA术后骨折愈合的关联性研究  

Association between Serum CTRP3 BGLAP sCD44 Levels with Fracture Healing in Patients with Traumatic Intertrochanteric Femoral Fractures Underwent Proximal Femoral Nail Anti-rotation

作　　者：何金海 邹国友 纪秉青 丁亚军 刘红兵 HE Jinhai;ZOU Guoyou;JI Bingqing(Yancheng No.1 People's Hospital,Yancheng First Hospital Affiliated of Nanjing University Medical College,Jiangsu Yancheng 224000,China)

机构地区：[1]江苏省盐城市第一人民医院/南京大学医学院附属盐城第一医院骨科,江苏盐城224000

出　　处：《河北医学》2024年第12期2091-2096,共6页Hebei Medicine

基　　金：江苏省老年健康科研项目,(编号:LKM2022074)。

摘　　要：目的:观察创伤性股骨粗隆间骨折(IFF)患者股骨近端防旋髓内钉内固定(PFNA)术后血清补体C1q/肿瘤坏死因子相关蛋白3(CTRP3)、骨钙素(BGLAP)、可溶性吞噬细胞糖蛋白-1(sCD44)水平变化,并分析其与骨折愈合效果的关联性。方法:纳入2019年1月至2023年12月本院收治112例创伤性IFF患者进行研究,通过测定患者PFNA术后血清CTRP3、BGLAP及sCD44水平变化,并分析这些指标水平与骨折愈合效果的关系。结果:112例患者接受PFNA治疗后有23例出现愈合不良,且PFNA术后愈合不良组血清CTRP3、BGLAP均明显低于愈合良好组,sCD44水平明显高于愈合良好组,差异有统计学意义(P<0.05)。单因素分析发现年龄、吸烟、手术时间与PFNA术后愈合不良有关,差异有统计学意义(P<0.05)。Logistic回归分析显示:年龄、手术时间及sCD44水平是影响PFNA术后愈合不良的危险因素,关联均有统计学意义(P<0.05),血清CTRP3、BGLAP水平是影响PFNA术后愈合不良的保护因素,关联均有统计学意义(P<0.05)。ROC曲线显示:CTRP3、BGLAP、sCD44评估PFNA术后愈合不良的AUC分别为0.703、0.743、0.724,而CTRP3+BGLAP+sCD44三项联合评估PFNA术后愈合不良的AUC为0.803,最大约登指数下的敏感度和特异度分别为0.957、0.528。结论:创伤性IFF患者PFNA术后血清CTRP3、BGLAP及sCD44水平降低与骨折愈合不良存在一定的关联性,并对骨折愈合效果具有较高的评估价值。Objective:To observe the serum levels of complement C1q/tumor necrosis factor-related protein 3(CTRP3),osteocalcin(Bglap)and soluble phagocytic glycoprotein-1(sCD44)in patients with traumatic intertrochanteric femoral fractures(IFF)underwent proximal femoral nail anti-rotation(PFNA),and to analyze their correlation with fracture healing effect.Methods:A total of 112 patients with traumatic IFF in the hospital from January 2019 to December 2023 were included in the study.The serum levels of CTRP3,BGLAP and sCD44 after PFNA were measured among all patients,and the association between these indicators and fracture healing effect was analyzed.Results:After PFNA treatment,twenty-three cases representing 112 patients had poor healing.The levels of serum CTRP3 and BGLAP in the poor healing group were significantly lower than those in the good healing group,while the sCD44 level was significantly higher(P<0.05).Univariate analysis found that age,smoking and surgical time were related to poor postoperative healing(P<0.05).Logistic regression analysis showed that age,surgical time and sCD44 level were risk factors affecting poor postoperative healing,and all the associations were statistically significant(P<0.05).Serum CTRP3 and BGLAP levels were protective factors for poor healing(P<0.05).Receiver operating characteristic(ROC)curves revealed that the area under the ROC curve(AUC)of CTRP3,BGLAP and sCD44 in evaluating poor healing after PFNA was 0.703,0.743 and 0.724,respectively,but the AUC of CTRP3+BGLAP+sCD44 in evaluating poor postoperative healing was 0.803,with the sensitivity and specificity under the maximum Youden index of 0.957 and 0.528 respectively.Conclusion:The decreases of serum CTRP3,BGLAP and sCD44 levels have a certain association with poor fracture postoperative healing in patients with traumatic IFF underwent PFNA,and have a high evaluated value on fracture healing effect.

关 键 词：股骨粗隆间骨折 股骨近端防旋髓内钉内固定 骨折愈合 补体C1q/肿瘤坏死因子相关蛋白3 骨钙素 可溶性吞噬细胞糖蛋白-1 

分 类 号：R687.3[医药卫生—骨科学]