| 股骨颈骨折内固定术后股骨头坏死与血清骨代谢及血管活性因子的关系及危险因素探究 |
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投稿时间：2020-10-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 窦志刚 |
DOU Zhi-gang |
漯河市中医院骨科, 河南漯河 462000 |
Department of Orthopaedics, Luohe Hospital of Chinese Medicine, Luohe 462000, Henan, China |
zhimi9496500@163.com |
| 王功磊 |
WANG Gong-lei |
漯河市中医院骨科, 河南漯河 462000 |
Department of Orthopaedics, Luohe Hospital of Chinese Medicine, Luohe 462000, Henan, China |
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| 庞寅田 |
PANG Yin-tian |
漯河市中医院骨科, 河南漯河 462000 |
Department of Orthopaedics, Luohe Hospital of Chinese Medicine, Luohe 462000, Henan, China |
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| 李红霞 |
LI Hong-xia |
漯河市中医院骨科, 河南漯河 462000 |
Department of Orthopaedics, Luohe Hospital of Chinese Medicine, Luohe 462000, Henan, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第3期，第215-219页 |
| DOI：10.12200/j.issn.1003-0034.2021.03.005 |
| 基金项目: |
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中文摘要:
目的：研究股骨颈骨折内固定术后股骨头坏死与血清骨代谢、血管活性因子的关系并分析危险因素。
方法：选择2016年4月至2019年4月接受复位内固定手术的150例股骨颈骨折患者，男83例，女67例；根据术后是否发生股骨头坏死分为坏死组32例和非坏死组118例，检测术前及术后1、3、5 d时的血清Ⅰ型胶原羧基端肽β特殊序列（β-C terminal cross-linked telopeptides of typeⅠ collagen，β-CTX），Ⅰ型前胶原氨基端延长肽（propeptide of typeⅠ procollagen，PINP），一氧化氮（nitric oxide，NO），内皮素-1（Endothelin-1，ET-1）的含量，比较两组间临床特征的差异并采用Logistic回归模型分析术后股骨头坏死的危险因素，采用ROC曲线分析血清指标预测术后股骨头坏死的价值。
结果：坏死组与非坏死组术前及术后1、3、5 d时的血清PINP、β-CTX含量比较差异无统计学意义（P>0.05），术前及术后5 d时的血清NO、ET-1含量比较差异无统计学意义（P>0.05），术后1、3 d时的血清NO、ET-1含量比较差异有统计学意义（P<0.05），骨折类型、术前牵引比例、复位质量比较差异有统计学意义（P<0.05）。Logistic回归分析显示，术后1 d时血清NO含量减少、ET-1含量增加及Ⅲ-Ⅳ型骨折、Ⅲ-Ⅳ级复位是发生股骨头坏死的危险因素；ROC曲线分析显示，术后1 d时的血清NO、ET-1含量对术后股骨头坏死具有预测价值，预测的最佳截点分别为26.55 μmol/L、7.785 μg/L。
结论：股骨颈骨折内固定术后股骨头坏死与血管活性因子NO、ET-1的异常有关，术后1 d时的血清NO、ET-1含量对术后股骨头坏死具有预测价值。 |
| 【关键词】股骨颈骨折 股骨头坏死 一氧化氮 内皮缩血管肽1 危险因素 |
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| Relationship and risk factors of osteonecrosis of femoral head after internal fixation of femoral neck fracture with serum bone metabolism and vasoactive factors |
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ABSTRACT
Objective: To study the relationship between osteonecrosis of femoral head after internal fixation of femoral neck fracture and serum bone metabolism,vascular active factors,and analyze the risk factors.
Methods: Total 150 patients with femoral neck fracture who underwent reduction and internal fixation from April 2016 to April 2019 were selected,including 83 males and 67 females. According to whether there was necrosis of femoral head after operation,they were divided into necrosis group(32 cases) and non necrosis group (118 cases). Before operation and 1,3,5 days after operation,the serum levels of beta-C terminal cross-linked telopeptides of typeⅠ collagen(β-CTX),N-telopeptide of typeⅠ procollagen(PINP),nitric oxide(NO),Endothelin-1(ET-1) were measured. The clinical characteristics of the two groups were compared. The risk factors of postoperative femoral head necrosis were analyzed by logistic regression model. The value of serum indexes in predicting postoperative femoral head necrosis was analyzed by ROC curve.
Results: There was no significant difference in the levels of serum PINP and β-CTX between necrotic group and non necrotic group before operation and 1,3 and 5 days after operation(P>0.05). There was no significant difference in the levels of serum NO and ET-1 before operation and 5 days after operation(P>0.05). There were significant differences in the levels of serum NO and ET-1(P<0.05),fracture type,preoperative traction ratio and reduction quality(P<0.05). Logistic regression analysis showed that the decrease of serum NO content and the increase of ET-1 content at 1 day after operation,Ⅲ-Ⅳ fracture and Ⅲ-Ⅳ reduction were the risk factors of femoral head necrosis;ROC curve analysis showed that serum NO and ET-1 content at 1 day after operation had predictive value for femoral head necrosis,and the best cut-off points were 26.55 μmol/L and 7.785 μg/L,respectively.
Conclusion: The content of serum NO and ET-1 on the first day after operation can predict the necrosis of femoral head. |
| KEY WORDS Femoral neck fractures Femur head necrosis Nitric oxide Endothelin-1 Risk factors |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 窦志刚,王功磊,庞寅田,李红霞.股骨颈骨折内固定术后股骨头坏死与血清骨代谢及血管活性因子的关系及危险因素探究[J].中国骨伤,2021,34(3):215~219 |
| 英文格式: | DOU Zhi-gang,WANG Gong-lei,PANG Yin-tian,LI Hong-xia.Relationship and risk factors of osteonecrosis of femoral head after internal fixation of femoral neck fracture with serum bone metabolism and vasoactive factors[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(3):215~219 |
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