降钙素基因相关肽对脑损伤骨折患者骨折愈合的影响

Significance of Calcitonin Gene-related Peptide on Fracture Healing of Patients with Traumatic Brain Injury and Fracture

目的测定脑损伤合并骨折患者血清中降钙素基因相关肽(CGRP),探讨CGRP对脑损伤后骨折愈合加速的机制。方法选取临床健康体检者10例、单纯骨折患者20例、单纯脑损伤患者60例,脑损伤并骨折患者60例(脑损伤按GCS评分分轻中重3个亚组),采用放射免疫法检测各组伤后24 h、3 d、5 d、7 d不同时间点血清CGRP的含量。结果损伤后各组血清CGRP含量明显升高,而后逐渐降低,其中单纯脑损伤与脑损伤合并骨折组各亚组在时间点差异无统计学意义(P>0.05);伤后24 h、3 d、5 d,脑损伤组、脑损伤骨折组中度、重度脑损伤组与单纯骨折组比较CGRP含量明显升高,差异有统计学意义(P<0.05),与轻度脑损伤组,差异无统计学意义(P>0.05),7 d时重度脑损伤组CGRP含量明显高于轻度脑损伤组,差异有统计学意义(P<0.05)。结论脑损伤骨折患者骨痂量大、骨折愈合加速,而脑损伤骨折后患者血清中CGRP含量明显升高,尤以中重度脑损伤明显,结合以往研究可以推测CGRP可能是脑损伤后骨折愈合加速的因素之一。

Objective To observe the plasma levels of calcitonin gene-related peptide in patients with traumatic brain injury combined fracture and to explore the mechanism of calcitonin gene-related peptide accelerating the fracture healing.Methods Sixty patientswith traumatic brain injury combined fracture were subjected to the brain injury and fracture group（the patients were divided into 3 groups according to the Glasgow coma scale：mild,moderate,severe group）,twenty patients who underwent fracture were subjected to the pure fracture group：ten healthy people were selected as control group.The plasma levels of calcitonin gene-related peptide at the 24th hour,3rd day,5th day,7th day in all subjects after injury and the controls were measured by radioimmune assay.Results The plasma levels of calcitonin gene-related peptide increased first and then decreased after injury in all groups,the plasm levels of calcitonin gene-related peptide between the subgroups of the brain injury combined fracture group and the pure brain injury group had no significant differences at all time points（P0.05）;the plasma levels of calcitonin gene-related peptide of the pure brain injury group and the brain injury combined fracture group were much higher than those of the pure fracture group at the 24th hour,3rd day,5th day（P0.05）;there were no significant difference between the subgroup of the mild brain injury group or the mild brain injury combined group and the pure fracture group at all the time pionts（P0.05）,the level of plasma calcitonin gene-related peptide of the severe brain injury were much higher than that of the mild injury brain subgroup at the 7th day（P0.05）.Conclusion The traumatic brain injury combined fracture patients has much more callus than the fracture patients,and has a faster rate in healing;the plasma levels of calcitonin gene-related peptide of the traumatic brain injury combined fracture increase,especially with severe traumatic brain injury,calcitonin gene-related peptide maybe a factor accelerate the rate of frature healing and the levels of calcitonin gene-related peptide may be very much correlation with the rate of fracture healing.