血清炎症指标、D–二聚体及骨生化指标变化在骨折愈合中的价值  

Value of changes of serum inflammatory indexes,D-dimer and bone biochemical indexes in fracture healing

作　　者：曹玉巧 杨永红 杨妹音 CAO Yu-Qiao;YANG Yong-Hong;YANG Mei-Yin(Department of Laboratory Medicine,Beijing Jishuitan Hospital Guizhou Hospital,Guiyang 550081,China)

机构地区：[1]北京积水潭医院贵州医院检验科,贵阳550081

出　　处：《实验室检测》2024年第9期103-106,共4页Laboratory Testing

摘　　要：目的探讨分析血清炎症指标、D–二聚体(D-D)以及骨生化指标变化在骨折患者伤口愈合中的价值。方法回顾性分析2021年3月—2023年2月本院收治的92例骨折患者的病例资料,分为延迟组(n=47,骨折延迟愈合)和正常组(n=47,骨折正常愈合)。比较两组患者超敏C–反应蛋白(hs-CRP)、降钙素原(PCT)、D-D水平以及骨生化指标(骨钙素(BGP)、I型前胶原氨基端原肽(PINP)、I型胶原交联羧基末端肽(CTX)、骨碱性磷酸酶(BALP))差异,采用Pearson分析上述指标与骨折延迟愈合的相关性。以受试者工作曲线(ROC)评估以上指标预测骨折延迟愈合的预测价值。结果延迟组hs-CRP、PCT、D-D、CTX水平均高于正常组(P<0.05),延迟组BGP、PINP、BALP水平均低于正常组(P<0.05),骨折患者血清hs-CRP、PCT、D-D、CTX均与骨折延迟愈合呈正相关(P<0.05),骨折患者BGP、PINP、BALP均与骨折延迟愈合呈负相关(P<0.05)。ROC曲线中,hs-CRP、PCT、D-D、CTX、BGP、PINP、BALP水平预测骨折延迟愈合的曲线下面积(AUC)分别为0.693、0.810、0.722、0.763、0.746、0.868、0.839,敏感度分别为59.57%、59.57%、72.34%、59.57%、85.11%、93.62%、76.60%,特异度分别为78.72%、97.87%、65.96%、89.36%、59.57%、72.34%、80.85%。结论hs-CRP、PCT、D-D与骨生化指标均与骨折患者骨折延迟愈合密切相关,临床应予以重视。Objective To explore and analyze the value of serum inflammatory indexes,D-dimer(D-D)and bone biochemical indexes in wound healing of patients with fractures.Methods The clinical data of 92 patients with fracturesin the hospitalwere retrospectively analyzed from March 2021 to February 2023.The above patients were divided into delayed group(n=47,delayed fracture healing)and normal group(n=47,normal fracture healing).The levels of high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),D-D and bone biochemical indexes bone gla protein(BGP),type I procollagen amino terminal peptide(PINP),type I collagen cross-linked carboxy terminal peptide(CTX),bone alkaline phosphatase(BALP)were compared between groups.Pearson analysis was used to analyze the correlation between the above indexes and delayed fracture healing.Receiver operating characteristic curve(ROC)was adopted to evaluate the predictive value of the above indexeson predicting delayed fracture healing.Results The levels of hs-CRP,PCT,D-D and CTX in delayed group were higher than those in normal group(P<0.05)while the levels of BGP,PINP and BALP were lower than those in normal group(P<0.05).Serum hs-CRP,PCT,D-D and CTX in patients with fractures were positively correlated with delayed fracture healing(P<0.05),and BGP,PINP and BALP were negatively correlated with delayed fracture healing(P<0.05).Under the ROC curve,the areas under the curves(AUCs)of hs-CRP,PCT,D-D,CTX,BGP,PINP,and BALP in predicting delayed fracture healing were 0.693,0.810,0.722,0.763,0.746,0.868 and 0.839,the sensitivities were 59.57%,59.57%,72.34%,59.57%,85.11%,93.62%and 76.60%,and the specificities were 78.72%,97.87%,65.96%,89.36%,59.57%,72.34%and 80.85%respectively.Conclusion hs-CRP,PCT,D-D and bone biochemical indexes are closely related to delayed fracture healing in patients with fractures,which should be paid attention to in clinical practice.

关 键 词：骨折 C-反应蛋白 骨生化指标 骨折延迟愈合 相关性 

分 类 号：R683[医药卫生—骨科学] R446.1[医药卫生—外科学]