血清IL-17、VILIP-1及8-OHdG对老年股骨粗隆间骨折患者发生术后认知功能障碍的预测价值  

Predictive value of serum IL-17,VILIP-1 and 8-OHdG in postoperative cognitive impairment occurrence in elderly patients with intertrochanteric femoral fracture

作　　者：袁之木[1] 刘建民[1] 孙文建[1] 邱燕森[2] YUAN Zhimu;LIU Jianmin;SUN Wenjian;QIU Yansen(Department of Orthopedics,Affiliated Nanjing Tongren Hospital,Medical College,Southeast University,Nanjing,Jiangsu 211102,China;Wound Outpatient Department,Affiliated Nanjing Tongren Hospital,Medical College,Southeast University,Nanjing,Jiangsu 211102,China)

机构地区：[1]东南大学医学院附属南京同仁医院骨科,江苏南京211102 [2]东南大学医学院附属南京同仁医院伤口门诊,江苏南京211102

出　　处：《检验医学与临床》2025年第9期1246-1250,1256,共6页Laboratory Medicine and Clinic

基　　金：2021年度南京市卫生科技发展专项资金项目(YKK21247);江苏省优势学科建设工程项目(YSHL2001-1241)。

摘　　要：目的研究血清白细胞介素-17(IL-17)、视椎蛋白样蛋白1(VILIP-1)及8-羟脱氧鸟苷(8-OHdG)对老年股骨粗隆间骨折(IFF)患者发生术后认知功能障碍(POCD)的预测价值,为临床诊疗提供参考。方法选取2020年1月至2023年12月南京同仁医院骨科收治的87例老年IFF患者作为研究对象,术后7 d采用蒙特利尔认知功能量表(MoCA)评估患者POCD情况,分为POCD组(MoCA评分<26分)、无POCD组(MoCA评分≥26分)。比较2组术前、术后1 d、术后3 d血清IL-17、VILIP-1及8-OHdG水平,并分析血清IL-17、VILIP-1及8-OHdG对老年IFF患者发生POCD的预测价值,分析血清IL-17、VILIP-1、8-OHdG不同水平老年IFF患者发生POCD的危险度,以相对危险度(RR)表示。结果POCD组26例、无POCD组61例。重复测量方差分析结果显示,2组不同时间血清IL-17、VILIP-1、8-OHdG变化存在时间效应、组间效应、交互效应,差异均有统计学意义(P<0.05)。2组术后1 d、术后3 d血清IL-17、VILIP-1、8-OHdG水平均高于术前(P<0.02),2组术后3 d血清IL-17、VILIP-1、8-OHdG水平均高于术后1 d(P<0.02)。多变量方差分析结果显示,POCD组术后1、3 d血清IL-17、VILIP-1、8-OHdG水平均高于无POCD组(P<0.05)。术后1、3 d血清IL-17、VILIP-1、8-OHdG 3项指标联合预测老年IFF患者发生POCD的曲线下面积(AUC)分别为0.925(95%CI:0.848~0.970)、0.945(95%CI:0.874~0.983)。术后1、3 d血清IL-17、VILIP-1、8-OHdG高水平的老年IFF患者发生POCD的风险均是IL-17、VILIP-1、8-OHdG低水平患者的数倍(术后1 d:RR=2.901、4.903、3.258,P<0.001;术后3 d:RR=6.171、6.429、4.298,P<0.001)。结论血清IL-17、VILIP-1、8-OHdG水平与老年IFF患者发生POCD关系密切,可作为预测POCD的标志物。Objective To investigate the predictive value of serum interleukin-17(IL-17),visinin-like protein 1(VILIP-1)and 8-hydroxydeoxyguanosine(8-OHdG)for postoperative cognitive dysfunction(POCD)occurrence in elderly patients with intertrochanteric femoral fractures(IFF)to provide reference for clinical diagnosis and treatment.Methods A total of 87 elderly patients with IFF admitted and treated in the orthopedic department of Nanjing Tongren Hospital from January 2020 to December 2023 were selected.The POCD status of the patients was evaluated by the Montreal Cognitive Assessment(MoCA)on postoperative 7 d.The patients were divided into the POCD group(MoCA score<26 points)and non-POCD group(MoCA score≥26 points).The serum IL-17,VILIP-1 and 8-OHdG levels before surgery,on postoperative 1,3 d were compared between the two groups,and the predictive value of serum IL-17,VILIP-1 and 8-OHdG for POCD in elderly patients with IFF was analyzed.The risk degree of different serum IL-17,VILIP-1 and 8-OHdG levels on POCD occurrence in elderly patients with IFF was analyzed,which was represent by the relative risk(RR).Results There were 26 cases in the POCD group and 61 cases in the non-POCD group.The results of repeated measures analysis of variance showed that the serum IL-17,VILIP-1 and 8-OHdG at different times in the two groups had the time effects,intergroup effects and interaction effects of,and the differences were statistically significant(P<0.05).The serum IL-17,VILIP-1 and 8-OHdG levels on postoperative 1,3 d in the two groups were higher than those before surgery(P<0.02),and the serum IL-17,VILIP-1 and 8-OHdG levels on postoperative 3 d in the two groups were higher than those on postoperative 1 d(P<0.02).The results of multivariate analysis of variance showed that the serum IL-17,VILIP-1 and 8-OHdG levels on postoperative 1,3 d in the POCD group were higher than those in the non-POCD group(P<0.05).The area under the curve(AUC)of the three indicators combination on postoperative 1,3 d for predicting POCD occurrence in el

关 键 词：股骨粗隆间骨折 视椎蛋白样蛋白1 白细胞介素-17 8-羟脱氧鸟苷 老年 认知功能障碍 

分 类 号：R446.11[医药卫生—诊断学] R683.42[医药卫生—临床医学]