摘要
目的分析血清胰岛素样生长因子-1(IGF-1)、β-Ⅰ型胶原羧基端肽(β-CTX)水平与胫骨平台骨折患者术后感染及骨痂X线评分的关系。方法回顾性分析2020年1月至2023年1月北京市仁和医院收治的90例胫骨平台骨折患者的临床资料,根据术后感染情况分为感染组(n=23例)和未感染组(n=67例)。对比两组的临床资料,应用二元Logistic回归模型分析胫骨平台骨折患者术后感染影响因素;采用Spearman相关系数分析IGF-1、β-CTX与术后3个月的骨痂X线评分的相关性,绘制受试者工作特征(ROC)曲线分析IGF-1和β-CTX对患者术后骨折愈合情况的预测价值。结果两组一般资料中性别、损伤机制、骨质疏松情况、合并糖尿病情况、手术时间、联合应用抗生素情况以及住院天数比较差异均无统计学意义(P>0.05);感染组中年龄≥60岁、开放性骨折损伤类型、有遗留死腔的比例均高于未感染组,血清IGF-1和β-CTX水平均低于未感染组,差异有统计学意义(P<0.05);骨痂X线分级Ⅰ~Ⅱ级患者的血清IGF-1和β-CTX水平低于骨痂X线分级Ⅲ~Ⅳ级患者,差异有统计学意义(P<0.05);年龄≥60岁(OR=3.840,95%CI:1.803~8.178)、开放行骨折损伤类型(OR=3.656,95%CI:1.705~7.834)、有遗留死腔(OR=3.407,95%CI:1.670~6.955)、<中位数水平的血清IGF-1(OR=2.578,95%CI:1.388~4.789)和β-CTX(OR=2.550,95%CI:1.262~5.153)的胫骨平台骨折患者术后感染风险更高(P<0.05);血清IGF-1和β-CTX水平与胫骨平台骨折患者术后骨痂X线评分均呈正相关(r=0.671、0.699,P<0.05);血清IGF-1、β-CTX水平及二者联合预测胫骨平台骨折患者术后骨折愈合情况的AUC分别为0.799、0.832、0.884,敏感度分别为0.727、0.727、0.909,特异性分别为0.785、0.798、0.772。结论胫骨平台骨折患者术后感染情况与年龄、损伤类型、遗留死腔、血清IGF-1和β-CTX水平有关,临床可通过检测IGF-1和β-CTX水平变化预测患者术后骨折愈合情况。
Objective To analyze the relationship between serum insulin-like growth factor-1(IGF-1)andβ-cross-linked ctelopeptide of type I collagen(β-CTX)levels and postoperative infection and cal-lus X-ray score in patients with tibial plateau fractures.Methods The clinical data of 90 patients with tibial plateau fractures at Beijing Renhe Hospital were retrospectively analyzed from January 2020 to January 2023.Based on the postoperative infection status,they were divided into an infection group(n=23)and a non-infec-tion group(n=67).The clinical data between the two groups were compared,and the influencing factors of postoperative infection in patients with tibial plateau fractures were analyzed using binary logistic regression model.Spearman correlation coefficient was used to analyze the correlation between IGF-1,β-CTX and callus X-ray score at 3 months after surgery.A receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of IGF-1 andβ-CTX on postoperative fracture healing status.Results There were no sta-tistical differences in general data regarding gender,injury mechanism,osteoporosis,diabetes mellitus,surgi-cal time,combined application of antibiotics and hospitalization days between the two groups(P>0.05).The proportion of patients with age≥60 years old,open fracture injuries and residual dead space in the infection group was higher than that in the non-infection group(P<0.05).The levels of serum IGF-1 andβ-CTX were lower in the infection group than those in the non-infection group(P<0.05).Serum IGF-1 andβ-CTX in pa-tients with callus X-ray gradeⅠ~Ⅱwere lower than those in patients with callus X-ray gradeⅢ~Ⅳ(P<0.05).Patients with age≥60 years old(OR=3.840,95%CI:1.803-8.178),type of open fracture injury(OR=3.656,95%CI:1.705-7.834),residual dead space(OR=3.407,95%CI:1.670-6.955),serum IGF-1<median level(OR=2.578,95%CI:1.388-4.789)andβ-CTX<median level(OR=2.550,95%CI:1.262-5.153)had a higher risk of postoperative infection(P<0.05).Serum IGF-1 andβ-CTX levels were posi
作者
张伟学
王猛
姜良德
韩奇
王力文
ZHANG Weixue;WANG Meng;JIANG Liangde;HAN Qi;WANG Liwen(Department of Orthopedics,Beijing Renhe Hospital,Beijing,China,102600)
出处
《分子诊断与治疗杂志》
2024年第9期1708-1712,共5页
Journal of Molecular Diagnostics and Therapy
基金
北京市自然科学基金项目(7222057)。
关键词
血清胰岛素样生长因子-1
β-Ⅰ型胶原羧基端肽
胫骨平台骨折
术后感染
骨痂X线评分
Serum insulin-like growth factor-1
β-cross-linked ctelopeptide of type I collagen
Tibial plateau fractures
Postoperative infection
Callus X-ray score
