摘要
目的探讨血清骨织素(OSTN)联合Ⅰ型前胶原氨基端前肽(PⅠNP)检测对老年股骨粗隆间骨折(IFF)股骨近端防旋髓内钉(PFNA)术后髋关节功能不良的预测价值。方法选取2019年2月至2021年12月于河南省黄河三门峡医院骨科行PFNA术的老年IFF患者200例,根据术后1年Harris髋关节功能评分将其分为不良组(51例)和优良组(149例)。比较两组临床资料及血清OSTN、PⅠNP水平差异,分析老年IFF患者PFNA术后髋关节功能不良的影响因素,通过受试者操作特征(ROC)曲线分析血清OSTN、PⅠNP水平对老年IFF患者PFNA术后髋关节功能不良的预测价值。结果不良组年龄、术前有合并症占比、术前美国麻醉医师协会分级≥Ⅲ级占比、术前Evans-Jensen分型≥Ⅲ型占比、重度骨质疏松占比及血清OSTN、PⅠNP水平均高于优良组,差异有统计学意义(P<0.05)。多因素分析结果显示,年龄、术前合并症、术前美国麻醉医师协会分级、术前Evans-Jensen分型、骨质疏松及血清OSTN、PⅠNP水平均为老年IFF患者PFNA术后髋关节功能不良的独立影响因素(P<0.05)。ROC曲线分析结果显示,血清OSTN、PⅠNP水平联合预测老年IFF患者PFNA术后髋关节功能不良的曲线下面积大于二者单独预测(P<0.05)。结论老年IFF患者血清OSTN、PⅠNP水平升高与PFNA术后髋关节功能不良有关,可能成为其辅助预测指标。
Objective To investigate the prognostic value of serum osteosin(OSTN)combined with procollagen typeⅠN-terminal propeptide(PⅠNP)in predicting hip dysfunction after proximal femoral nail antirotation(PFNA)in elderly pa-tients with intertrochanteric fracture of femur(IFF).Methods A total of 200 elderly IFF patients who underwent PFNA surgery in the Department of Orthopedics of Yellow River Sanmenxia Hospital,Henan Province from February 2019 to December 2021 were selected and divided into adverse group(51 cases)and excellent group(149 cases)according to the Harris hip function score at one year after surgery.The clinical data and serum OSTN,PⅠNP levels were compared between the two groups,and the influencing factors of hip dysfunction in elderly IFF patients after PFNA surgery were analyzed.The predictive value of serum OSTN and PⅠNP levels in elderly IFF patients after PFNA surgery was analyzed by receiver operating characteristics(ROC)curve.Results Age,proportion of complications before surgery,proportion of American Society of Anesthesiologists rating≥Ⅲbefore surgery,proportion of Evans-Jensen classification≥Ⅲbefore surgery,proportion of severe osteoporosis,and serum OSTN,PⅠNP levels in the adverse group were higher than those in the excellent group,and the differences were statistically significant(P<0.05).The results of multivariate analysis showed that age,preoperative comorbidities,American Society of Anesthesiologists rating be fore surgery, Evans-Jensen classification before surgery, osteoporosis, and serum OSTN, PⅠNP levels were independent influencing factors for hip dysfunction in elderly IFF patients after PFNA surgery (P<0.05). ROC curve analysis results showed that the area under the curve of the combined prediction of serum OSTN and PⅠNP levels of hip dysfunction in elderly IFF patients after PFNA was larger than that of the two alone (P<0.05). Conclusion The elevated serum OSTN and PⅠNP levels in elderly IFF patients are associated with hip dysfunction after PFNA surgery, and may be auxiliary predictors of IFF.
作者
翟江波
衡德忠
姚鹏
ZHAI Jiangbo;HENG Dezhong;YAO Peng(Department of Orthopedics,Yellow River Sanmenxia Hospital,Henan Province,Sanmenxia472000,China;Clinical Laboratory,Yellow River Sanmenxia Hospital,Henan Province,Sanmenxia472000,China)
出处
《中国医药导报》
CAS
2023年第27期90-94,共5页
China Medical Herald
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20191444)
