血清胰岛素样生长因子1在骨折合并脑损伤患者血清中的表达及其意义

Expression and effect of insulin-like growth factor-1 on bone fractures associated with cerebral trauma patients

目的 探讨血清胰岛素样生长因子1（IGF-1）在骨折合并脑损伤中的表达及其意义.方法 选择2011年11月至2012年12月在成都医学院第一附属医院住院患者30例,根据其受伤情况分为3组,单纯骨折组、骨折合并脑外伤组及单纯脑外伤组,每组10例.正常对照组10例为门诊体检的健康人群.每例于伤后6h内（超过6h者于入院时）、24、72、168 h,正常对照组于体检时、体检后24、72、168 h抽取外周静脉血5 ml,使用抗体芯片技术测定IGF-1的浓度.结果 伤后6、24、72、168 h,单纯脑外伤组IGF-1含量分别为（2.13 ±0.21）、（2.22±0.19）、（2.94 ±0.22）、（5.31±0.22） μg/L;单纯骨折组分别为（2.08±0.18）、（2.30±0.21）、（3.02 ±0.27）、（5.24±0.30） μg/L;脑损伤合并骨折组含量分别为（3.91±0.23）、（5.42±0.21）、（8.54±0.23）、（13.11±0.28） μg/L;正常对照组体检时、体检后24、72、168 h IGF-1含量分别为（2.11±0.19）、（2.05 ±0.17）、（2.10±0.20）、（2.08±0.17） μg/L.单纯脑外伤组和单纯骨折组伤后72 h血清IGF-1含量分别为正常对照组的1.4、1.4倍,168 h分别为正常对照组的2.5、2.5倍.骨折合并脑外伤组伤后6h血清IGF-1含量较正常对照组即明显升高（P＜0.05）,为正常对照组的1.9倍,24 h为正常对照组的2.6倍,72 h可达正常对照组的4.1倍,168 h可达正常对照组的6.3倍.骨折合并脑外伤组与单纯骨折组或单纯脑外伤组IGF-1水平比较,差异均有统计学意义（均P＜0.05）.结论 骨折合并脑外伤患者IGF-1含量早期即明显升高,提示IGF-1在早期即加速骨折愈合.

Objective To analyze the relation between the concentration of insulin-like grouth factor-1 （IGF-1） and bone fracture healing after cerebral trauma.Methods Thirty patients were equally divided into three groups including alone fracture,alone cerebral trauma and fractures associated with cerebral trauma.Healthy adults were chosen from the department of outpatient.Venous blood was obtained at 6,24,72 and 168 hours after injury.It was coagulated for twenty minutes at room temperature,centrifuged to get the serum and preserved under -20 ℃ temperature.Experimentation was operated rigorously following explanation of case of IGF-1.Concentration of IGF-1 in all sample was counted.Results 6,24,72,168 hours after injury,in traumatic brain alone group,IGF-1 was （2.13±0.21）,（2.22±0.19）,（2.94±0.22）,（5.31 ±0.22） μg / L; 6,24,72,168 hours after injury,IGF-1 of traumatic brain alone group was （2.13 ± 0.21）,（2.22 ± 0.19）,（2.94 ±0.22）,（5.31 ±0.22） μg/ L; IGF-1 of fracture group was （2.08 ±0.18）,（2.30 ±0.21）,（3.02 ±0.27）,（5.24±0.30） μg/ L; IGF-1 of brain injury and fracture group was （3.91 ±0.23）,（5.42±0.21）,（8.54±0.23）,（13.11 ±0.28） μg/ L; IGF-1 of the normal control group was （2.11 ±0.19）,（2.05±0.17）,（2.10 ± 0.20）,（2.08 ± 0.17） μg / L.24 h after injury,IGF-1 increased a little in the groups of alone cerebral trauma and alone fracture.Conclusions Concentration of IGF-1 in the patients with fracture associated with cerebral trauma increases obviously at early time.IGF-1 may be able to accelerate the process of fracture healing during early time after cerebral trauma.