摘要
目的研究胫骨骨折髓内钉固定术患者血清成纤维细胞生长因子-2(FGF-2)、胰岛素样生长因子-1(IGF-1)、可溶性细胞间黏附分子-1(sICAM-1)水平与骨折愈合的关系。方法2017年3月-2018年7月重庆市开州区中医院骨二科收治行髓内钉固定术的胫骨骨折患者46例,男性25例,女性21例;平均年龄(37.47±7.42)岁;骨折AO分型:A型24例,B1型17例,B2型5例。利用酶联免疫吸附法(ELISA)检测患者的血清FGF-2、IGF-1、sICAM-1水平并分析其与骨折愈合的关系。结果术后1d时,患者的血清FGF-2、IGF-1和sICAM-1浓度相较于术前比较均差异无统计学意义(P>0.05)。术后1、4周时,血清FGF-2、IGF-1和sICAM-1浓度相较于术前比较差异均有统计学意义(P<0.05)。骨不连和正常愈合者FGF-2、IGF-1和sICAM-1血清浓度比较差异均有统计学意义(P<0.05);联合三项检测预测骨不连的价值最高且术后4周为预测最优时间。结论胫骨骨折髓内钉固定术后骨不连患者血清FGF-2、IGF-1下降而sICAM-1明显升高,联合三项指标在预测髓内钉固定术后骨不连具有重要价值,且术后4周为最佳预测时间。
Objective To study the relationship between serum levels of fibroblast growth factor-2(FGF-2),IGF-1,sICAM-1 and fracture healing in patients with tibial fracture treated with intramedullary nailing.Methods From Mar.2017 to Jul.2018,patients with tibial fracture who underwent intramedullary nailing were selected as the study subjects.There were 25 males and 21 females with an average age of(37.47±7.42)years;Fracture AO classification indicated 24 cases of type A,17 cases of type B1,and 5 cases of type B2.Serum levels of FGF-2,IGF-1 and sICAM-1 were measured by enzyme-linked immunosorbent assay(ELISA)and their relationship with fracture healing was analyzed.Results The serum levels of FGF-2,IGF-1 and sICAM-1 at 1 day after operation had no significant difference compared with those before operation(P>0.05).At 1 and 4 weeks after operation,the serum levels of fibroblast growth factor-2,IGF-1 and sICAM-1 were significantly different from those before operation(P<0.05).The combined three tests had the highest value in predicting nonunion and the optimal time was 4 weeks after operation.Conclusion The serum levels of FGF-2 and IGF-1 decreased and sICAM-1 increased significantly in patients with nonunion after intramedullary nailing fixation of tibial fractures.Combination of these three indicators has important value in predicting nonunion after intramedullary nailing fixation,and the best predictive time is 4 weeks after operation.
作者
刘善明
赵元
陈黎兵
胡涛
LIU Shan-ming;ZHAO Yuan;CHEN Li-bing;HU Tao(the Second Orthopaedic Department,Congqing Kaizhou TCM Hospital,Chongqing 405400,China)
出处
《创伤外科杂志》
2019年第11期846-849,共4页
Journal of Traumatic Surgery
关键词
胫骨骨折
延迟愈合
血清浓度
骨不连
tibial fracture
delayed union
serum levels
bone nonunion
