骨折延迟愈合患者血清粘附分子水平变化的临床意义

Study on the level changes of serum adhesion molecules in the patients with fracture nonunion

目的探讨骨折延迟愈合患者血清可溶性细胞间粘附分子-1(sICAM-1)、血管细胞粘附分子-1(sVCAM-1)水平的变化及其临床意义。方法选取48例骨折愈合延迟患者为观察组,另取60例健康成人、60例骨折急性期患者及63例骨折愈合患者作为对照组,采用酶联免疫吸附法(ELISA)检测sICAM-1、sVCAM-1水平,并对结果进行统计分析。结果骨折延迟愈合患者循环中sICAM-1、sVCAM-1分别为(206.95±28.01)μg/L、(626.19±34.89)μg/L,较健康对照组[分别为(108.29±16.47)μg/L、(324.87±20.40)μg/L]及骨折愈合患者[分别为(112.74±17.68)μg/L、(340.21±25.81)μg/L]升高,而较骨折急性期患者降低[分别为(306.42±43.77)μg/L、(923.50±42.34)μg/L],差异均具有统计学意义(P<0.01)。结论 sICAM-1、sVCAM-1在骨折延迟愈合患者中持续升高,反映机体存在慢性炎症反应状态,对骨折患者血清sICAM-1、sVCAM-1进行动态监测可能有助于预测骨折愈合不良的发生。

Objective To explore the relationship between the level changes of serum solute intracellular adhesion molecule 1（sICAM-1）and solute vascular adhesion molecule 1（sVCAM-1）in patients with fracture nonunion.Methods 48 cases of patients with fracture nonunion were selected as observation group,while 60 healthy adults,60 patients with acute phase of bone fracture and 63 cases with normal bone healing were selected as control group.The serum level of sICAM-1 and sVCAM-1 was detected by ELISA.The results were statistical analysed by PASW Statistics 18.0.Results The serum level of sICAM-1 and sVCAM-1 [（206.95±28.01）μg/L,（626.19±34.89）μg/L respectively] in the fracture nonunion group were significantly higher than those in the healthy adults group [（108.29±16.47）μg/L,（324.87±20.40）μg/L respectively] and those in the normal healing group[（112.74±17.68）μg/L,（340.21±25.81）μg/L respectively],（All the P0.01）,while they were lower than those in acute bone fracture patients [（306.42±43.77）μg/L,（923.50±42.34）μg/L respectively]（P0.01）.Conclusion The sICAM-1 and sVCAM-1 remains at high level in the patients with fracture nonunion,which may show a prolonged inflammatory status of the body.Dynamic monitoring of sICAM-1 and sVCAM-1 in patients with bone fracture may be used to predict fracture nonunion.