摘要
目的 探讨血清炎性因子在骨折延迟愈合患者富血小板血浆治疗中的变化。方法 选取2020年4月—2021年4月我院收治的98例骨折患者,均予以富血小板血浆联合钢板内固定手术治疗,根据术后6个月内是否发生骨折延迟愈合分为延迟愈合组(37例)和正常愈合组(61例)。分别于骨折后1、4、8、12周采集患者血清样本,采用酶联免疫吸附法检测血清人可溶性细胞间粘附分子-1(sICAM-1)、人可溶性血管细胞粘附分子-1(sVCAM-1)、肿瘤坏死因子-α(TNF-α)等炎症因子水平,并绘制ROC曲线,评估其对骨折延迟愈合的预测价值。采用酶联免疫双抗体夹心法检测血清骨钙素(BGP)、Ⅰ型胶原氨基端肽原(PINP)、碱性磷酸酶(ALP)、胰岛素样生长因子-1(IGF-1)等骨生化代谢指标水平,并采用Pearson分析骨生化代谢指标与炎症因子的关系。结果 骨折1周时,两组患者血清sICAM-1、sVCAM-1、TNF-α等炎症因子水平比较差异无统计学意义(P>0.05);骨折4、8、12周时,延迟愈合组患者血清sICAM-1、sVCAM-1、TNF-α等炎症因子水平均高于正常愈合组(P<0.05),且随着时间推移,两组患者血清sICAM-1、sVCAM-1、TNF-α水平先升高后降低,但延迟愈合组炎症因子水平波动较正常愈合组更明显(P<0.05)。骨折1周时,两组患者血清BGP、PINP、ALP、IGF-1等骨生化代谢指标水平比较差异无统计学意义(P>0.05),且两组各时间点血清ALP水平比较差异无统计学意义(P>0.05);骨折4、8、12周时延迟愈合组患者血清BGP水平逐渐升高并高于正常愈合组,血清IGF-1水平逐渐升高但低于正常愈合组,骨折8、12周时延迟愈合组患者血清PINP水平低于正常愈合组(P<0.05)。Pearson相关性分析结果显示,血清sICAM-1、sVCAM-1、TNF-α等炎症因子水平与血清BGP呈正相关(r=0.523,P<0.001),与血清IGF-1呈负相关(r=-0.467,P<0.001)。ROC曲线分析结果显示,骨折8周时,血清炎症因子水平诊断骨折延迟愈合的曲线�
Objective To investigate and analyze the changes of serum inflammatory factors in patients with delayed fracture healing in platelet-rich plasma therapy.Methods 98 fracture patients admitted to our hospital from April 2020 to April 2021 were selected and treated with platelet-rich plasma combined with steel plate internal fixation.According to whether delayed fracture union occurred within 6 months after operation,they were divided into delayed union group of 37 cases and 61 cases in the normal healing group.Serum samples were collected from patients at 1 week,4 weeks,8 weeks,and 12 weeks after fracture,and enzyme-linked immunosorbent assay was used to detect serum human soluble intercellular adhesion molecule-1(sICAM-1),human the levels of inflammatory factors such as soluble vascular cell adhesion molecule-1(sVCAM-1),tumor necrosis factor-α(TNF-α),and the ROC curve was drawn according to their levels to evaluate its predictive value for predicting delayed fracture union.Serum bone gla protein(BGP),procollagen typeⅠN-terminal propeptide(PINP),alkaline phosphatase(ALP),the levels of bone biochemical metabolism indexes such as insulin like growth factor-1(IGF-1),and the relationship between bone biochemical metabolism indexes and inflammatory factors were analyzed by Pearosn.Results At 1 week after fracture,there was no difference in serum sICAM-1,sVCAM-1,TNF-αand other inflammatory factor levels between the delayed union group and the normal union group(P>0.05).The levels of serum sICAM-1,sVCAM-1,TNF-αand other inflammatory factors in the healing group were higher than those in the normal healing group(P<0.05).TNF-αlevel first increased and then decreased,but the fluctuation of inflammatory factor levels in the delayed healing group was more obvious than that in the normal healing group(P<0.05).At 1 week after fracture,there was no difference in serum BGP,PINP,ALP,IGF-1 and other bone biochemical metabolism indexes between the delayed healing group and the normal healing group,and there was no difference i
作者
段文江
陈勇
丁一
刘国印
DUAN Wenjiang;CHEN Yong;DING Yi;LIU Guoyin(General Hospital of PLA Eastern Theater Command,Nanjing 210002,China)
出处
《西部医学》
2023年第8期1152-1157,共6页
Medical Journal of West China
基金
国家自然科学基金资助项目(82102547)
江苏省自然科学基金(青年科技人才专项资金)项目(2018省1458)。
关键词
炎性因子
骨生化代谢
骨折延迟愈合
富血小板血浆治疗
Inflammatory factors
Bone biochemical metabolism
Delayed fracture healing
Platelet-rich plasma therapy
