摘要
将2011年5月至2014年5月在我院住院治疗的106例新发老年髋部骨折患者随机分为两组，观察组52例，予塞来昔布和帕瑞昔布抗炎、止痛治疗，对照组54例，予氨酚羟考酮片和盐酸布桂嗪止痛治疗。术后第1天、第7天时观察组的炎症指标[CRP（26．2±5．4）与（10．4±2．8）mg／L、肿瘤坏死因子-α（40．6±6．1）与（31．8±5．3）ng／L、IL-6（22．3±5．7）与（18．3±5．2）ng／L及前列腺素E2（181．1±19．4）与（153．3±25．8）ng／L]水平，均低于对照组[（46．1±14．0）与（22．1±5．2）mg／L、（53．2±5．3）与（44．6±7．4）ng／L、（43．3±11．0）与（29．1±8．6）ng／L和（354．3±105．9）与（251．0±37．3）ng／L，均P〈0．05]；观察组患者的住院时间（11．0±2．2）d、肺部感染6例、神经系统异常3例，均低于对照组的（15．5±1．8）d、15例、11例（均P〈0．05）；观察组患者术后24h外周血CD4＋CD45＋T细胞比例低于对照组[（34．9±3．7）与（42．5±4．3）％]，而CD4＋Foxp3＋T细胞比例则显著高于对照组[（19．7±3．8）与（6．9±1．5）％]（均P〈0．05）。提示塞来昔布可以诱导CD4＋T细胞向CD4＋Foxp3＋T细胞分化，从而控制机体的炎症反应，显著改善老年髋部骨折患者的预后。
One hundred and six patients with hip fracture admitted in hospital from 2011 to 2014 were randomly divided into two groups： 52 patients received celecoxib and parecoxib （trial group） and 54 patients received oxycodone hydroehloride and bucinnazine （control group）. On dl and d7 after the surgery, serum levels of C-reactive protein [ （ 26.2 ± 5.4 ） and （ 10.4 ±2.8 ） mg/L ], tumor necrosis factor-α [ （ 40. 6 ± 6.1 ） and （31.8 ± 5.3） ng/L], interleukin-6 [ （ 22. 3 ± 5.7 ） and （ 18. 3± 5.2 ） ng/L] and prostaglandin E2 [ （ 181.1 ± 19.4） and （ 153.3 ±25.8） ng/L] in trial group were all significantly lower than those in control group [ （46. 1 ± 14.0） and （22. 1 ±5.2）mg/L, （53.2±5.3） and （44.6±7.4） ng/L, （43.3 ±11.0） and （29. 1 ±8.6）ng/L, （ 354. 3 ± 105.9 ） and （ 251.0±37. 3 ） ng/L, all P 〈 0051. The length of hospital stay [ （ 11.0 ±2. 2 ） d ], rate of lung infections （6/52） and neurological abnormality （3/52） in trial group were significantly lower than those in control group [（15.5 ±1.8） d, 15/54 and 11/54, all P 〈0.05]. The expression of CD4＋ C1M5＋ T cells [（34.9±3.7）% vs. （42.5 ±4.3）%] was reduced and CD4＋Foxp3＋ Tcells [（19.7 ±3.8）% vs. （6.9 ± 1.5） % ] was increased at 24 h after surgery in trial group compared with control group（ all P 〈0.05）. The results indicates that caleeoxib can reduce the inflammatory reaction by promoting CD4＋ to Foxp3 ＋ CIM ＋T celldifferentiation and may improve the prognosis of elderly patients with hip fracture.
出处
《中华全科医师杂志》
2016年第2期147-150,共4页
Chinese Journal of General Practitioners
关键词
消炎药
非甾体
老年人
髋骨折
预后
Anti-inflammatory agents, non-steroidal
Aged
Hipfractures
Prognosis
