摘要
目的:探究血流变学指标、血清炎症因子水平变化在骨折延迟愈合患者中的临床意义。方法:回顾性分析2018年2月至2019年2月在本进行治疗的120例骨折患者的病历资料,按照术后4个月内骨折愈合情况分为两组,延迟愈合组68例,骨折正常愈合的正常愈合组52例;采用重复测量方差分析的方法分析两组患者术后1、4、8、12周血流变学指标及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)、人胰岛素生长因子-1(IGF-1)、血小板衍生生长因子(PDGF)、人碱性磷酸酶(ALP)水平。结果:重复测量方差分析结果显示红细胞刚性指数、红细胞聚集指数、血浆粘度、全血高切黏度、全血低切黏度、sICAM-1、SVCAM-1、TNF-α、IGF-1、PDGF和ALP时间因素及时间因素和分组的交互作用均有统计学意义(P<0.05)。事后多重比较显示,骨折4周、8周、12周,延迟愈合组红细胞刚性指数、红细胞聚集指数、血浆粘度、全血高切黏度、全血低切黏度、sICAM-1、SVCAM-1、TNF-α水平明显高于正常愈合组,IGF-1、PDGF、ALP水平明显低于正常愈合组,差异均有统计学意义(P<0.05)。结论:随着时间的延长,两组患者细胞刚性指数、红细胞聚集指数、血浆粘度、全血高切黏度、全血低切黏度、sICAM-1、SVCAM-1、TNF-α、IGF-1、PDGF和ALP水平均呈现先升高后降低的趋势,其中细胞刚性指数、红细胞聚集指数、血浆粘度、全血高切黏度、全血低切黏度、sICAM-1、SVCAM-1、TNF-α在延迟愈合骨折中随时间波动明显,IGF-1、PDGF和ALP水平则在正常骨折中波动明显。
Objective:To explore the clinical significance of changes of hemorheology indexes and serum inflammatory factors in patients with delayed union of fracture.Methods:The medical records of 120 fracture patients treated in our hospital from February 2018 to February 2019 were analyzed retrospectively.According to the condition of fracture healing within 4 months after operation,68 cases in delayed healing group and 52 cases in normal healing group were divided into two groups.The hemorheology indexes,serum soluble intercellular adhesion molecule-1(sICAM-1),soluble vascular cell adhesion molecule-1(sVCAM-1)and tumor damage were analyzed by means of repeated measurement of variance analysis The levels of TNF-α,IGF-1,PDGF and ALP were measured.Results:The results of repeated measurement analysis of variance showed that there were statistical significance(P<0.05)in RBC rigidity index,RBC aggregation index,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,sICAM-1,sVCAM-1,TNF-α,IGF-1,PDGF and ALP time factors,time factors and group interaction.After 4,8 and 12 weeks of fracture,the RBC rigidity index,RBC aggregation index,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,sICAM-1,sVCAM-1,TNF-αlevels in the delayed healing group were significantly higher than those in the normal healing group,and the levels of IGF-1,PDGF and ALP were significantly lower than those in the normal healing group(P<0.05).Conclusion:With the prolongation of time,the cell rigidity index,RBC aggregation index,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,sICAM-1,sVCAM-1,TNF-α,IGF-1,PDGF and ALP levels in the two groups increased first and then decreased,among which cell rigidity index,RBC aggregation index,plasma viscosity,whole blood high shear viscosity,whole blood low shear viscosity,sICAM-1,s VCAM-1 and TNF-αfluctuated significantly with time in delayed union fractures,while IGF-1,PDGF and ALP levels fluctuated significantly in normal fractures.
作者
徐向勇
余永斌
XU Xiangyong;YU Yongbin(The Second Staff Hospital of Wuhan Iron and steel Group,Hubei Wuhan 430085,China)
出处
《河北医学》
CAS
2020年第5期810-815,共6页
Hebei Medicine
基金
湖北省自然科学基金项目,(编号:2017CFL083)。
关键词
血流变学
炎症因子
骨折
延迟愈合
Hemorheology
Inflammatory factors
Fracture
Delayed union
