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创伤性骨折患者术后骨折愈合、骨代谢与表皮生长因子、管细胞黏附因子-1水平的关系

Relationships between fracture healing, bone metabolism and levels of epidermal growth factor, vascular cellular adhesion molecule-1 in patients with traumatic fracture

    摘要
  • 摘要:
    目的 探讨血清表皮生长因子(EGF)、血管细胞黏附因子-1(VCAM-1)水平对创伤性骨折患者术后骨折愈合、骨代谢的影响。
    方法 选取创伤性骨折患者158例为研究对象，根据术后4个月骨折端愈合情况分为正常愈合组117例、延迟愈合组41例。比较2组术后24 h血清EGF、VCAM-1水平、术后4个月骨密度值及血清骨代谢指标骨钙素(BGP)、骨碱性磷酸酶(BALP)、Ⅰ型前胶原氨基端原肽(PⅠNP)、骨抗酒石酸酸性磷酸酶(TRACP-5b)、Ⅰ型胶原交联羧基末端肽(CTX)水平。采用Pearson检验分析创伤性骨折患者术后24 h血清EGF、VCAM-1水平与骨密度值、骨代谢指标水平的相关性。
    结果 术后24 h, 延迟愈合组患者血清EGF水平低于正常愈合组患者, VCAM-1水平高于正常愈合组，差异有统计学意义(P＜0.05)。术后4个月，延迟愈合组骨密度值及BGP、BALP、PⅠNP水平低于正常愈合组, TRACP-5b、CTX水平高于正常愈合组，差异有统计学意义(P＜0.05)。创伤性骨折患者术后24 h血清EGF水平与术后4个月骨密度值及血清BGP、BALP、PⅠNP水平呈正相关(P＜0.05), 与TRACP-5b、CTX水平呈负相关(P＜0.05)。术后24 h血清VCAM-1水平与术后4个月骨密度值及血清BGP、BALP、PⅠNP水平呈负相关(P＜0.05), 与TRACP-5b、CTX水平呈正相关(P＜0.05)。
    结论 术后早期血清EGF、VCAM-1异常高水平可能预示着创伤性骨折患者的骨愈合延迟以及骨代谢异常。

     

    Abstract:
    Objective To investigate the effects of serum epidermal growth factor (EGF) and vascular cellular adhesion molecule-1 (VCAM-1) levels on fracture healing and bone metabolism in patients with traumatic fracture after surgery.
    Methods A total of 158 patients with traumatic fracture were selected and divided into normal healing group (117 cases) and delayed healing group (41 cases) according to the healing of fracture end at 4 months after operation. The levels of serum EGF and VCAM-1 at 24 h after operation as well as bone mineral density and serum bone metabolic indexes bone gla protein (BGP), bone alkaline phosphatase (BALP), N-terminal procollagen type Ⅰ propeptide (PⅠNP), tartrate-resistant acid phosphatase isoform 5b (TRACP-5B), type Ⅰ collage cross-linked-telopeptide (CTX) at 4 months after operation in two groups were compared. Pearson test was used to analyze the correlations of serum EGF and VCAM-1 levels with bone mineral density value and bone metabolism indexes levels in patients with traumatic fracture 24 h after operation.
    Results At 24 h after operation, the serum EGF level of patients in the delayed healing group was significantly lower, and the serum VCAM-1 level was significantly higher than that in the normal healing group (P < 0.05). At 4 months after operation, the bone mineral density, BGP, BALP and PⅠNP levels in the delayed healing group were significantly lower, and TRACP-5B and CTX levels were significantly higher than those in the normal healing group (P < 0.05). The serum EGF level at 24 h after surgery was positively correlated with bone mineral density, serum BGP, BALP and PⅠNP levels at 4 months after surgery, and negatively correlated with TRACP-5B and CTX levels in patients with traumatic fracture (P < 0.05). The serum VCAM-1 level at 24 h after operation was negatively correlated with bone mineral density value, serum BGP, BALP and PⅠNP levels at 4 months after operation, and positively correlated with TRACP-5B and CTX levels (P < 0.05). Conclusion Abnormal high levels of serum EGF and VCAM-1 in the early postoperative period may indicate delayed bone healing and abnormal bone metabolism in patients with traumatic fracture.

     

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