摘要
目的探讨骨折后患者应激水平对凝血功能变化与骨折愈合进度的影响。方法回顾性分析50例骨折患者（骨折组）及50例健康体检志愿者（对照组）临床资料，比较其氧化应激指标[超氧化物岐化酶（SOD）、丙二醛（MDA）]及凝血功能指标[血浆纤维蛋白原定量（Fib）、活化部分凝血酶时间（APFT）、凝血酶时间（TT）、凝血酶原时间（PT）]差异，经Spearman相关系数分析骨折患者应激水平同凝血功能指标的相关性；分析骨折患者应激水平同骨折愈合进度的相关性。结果骨折组和对照组受试者APTT、TT、PT等凝血功能指标检测结果比较，差异均无统计学意义（P〉0．05）；骨折组患者SOD水平明显低于对照组受试者，MDA及Fib水平则明显高于对照组受试者，差异均有统计学意义（P〈0．05）。Spearman分析结果显示：骨折组患者SOD水平同Fib水平呈负相关（P〈0．05），MDA水平同Fib水平呈正相关（P〈0．05），骨折组患者MDA水平同骨折愈合进程呈负相关（P〈0．05），SOD水平同骨折愈合进程呈正相关（P〈0．05）。结论创伤性骨折可引起机体应激反应，且应激反应程度同Fib水平及骨折愈合进程关系密切，需引起重视。
Objective To investigate the effect of stress level on blood coagulation and fracture healing in fracture patients. Methods The clinical data of 50 fracture patients （fracture group） and 50 healthy volunteers （control group） were analyzed retrospectively. The oxidative stress indexes [superoxide dismutase （SOD） and malondialdehyde （MDA）] and blood coagulation indexes [plasma fibrinogen （Fib）, activated partial thromboplastin time （AFFF）, thrombin time （TF）, and prothrombin time （PT）] were compared between the 2 groups. Correlation between stress level and coagulation indexes in the fracture patients was analyzed by Spear- man correlation coefficient. The correlation between stress level and the progress of fracture healing in fracture patients was analyzed. Results There were no significant differences in APTT, TT, PT or other blood co- agulation indexes between the 2 groups （ P 〉 0. 05 ）. The fracture group had a significantly lower SOD level but significantly higher MDA and Fib levels than the control group （ P 〈 0. 05）. Spearman analysis showed that the SOD level was negatively correlated to the Fib level （P 〈 0. 05） while the MDA level was positively correlated to the Fib level in the fracture group （ P 〈 0.05 ） . The MDA level was negatively correlated to the process of fracture healing （ P 〈 0. 05 ） while the SOD level was positively correlated to the process of fracture healing in the fracture group （ P 〈 0.05 ） . Conclusions Traumatic fracture can cause stress reaction. It should be kept in mind that the severity of stress reaction is closely related to the Fib level and the process of fracture healing.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第4期353-356,共4页
Chinese Journal of Orthopaedic Trauma
基金
东莞市医疗卫生一般项目（2016105101141）
关键词
骨折
氧化性应激
凝血酶时间
骨折愈合
Fractures, bone
Oxidative stress
Thrombin time
Fracture healing
