骨折合并脊髓损伤患者血清中转化生长因子β1变化:有利于促进骨折愈合

Serum transforming growth factor beta 1 contributes to bone healing in patients with bone fractures combined with spinal cord injuries

背景:研究表明,转化生长因子β1在单纯骨折愈合中可发挥重要作用,但在脊髓损伤合并骨折中,转化生长因子β1如何促进骨折愈合未见报道。目的:观察骨折合并脊髓损伤患者的血清中转化生长因子β1水平变化,探讨转化生长因子β1在骨折合并脊髓损伤中的作用机制。方法:收集新疆医科大学第一附属医院脊柱外科及创伤外科从2012年5月至2014年3月间的住院患者28例,并根据是否合并脊髓损伤分为2组,骨折合并脊髓损伤组患者12例、骨折无脊髓损伤组患者16例。分别于伤后第2,7,14,28天空腹时采外周静脉血,并采用酶联免疫法对血清转化生长因子β1质量浓度进行检测。结果与结论:纳入的28例患者中,在损伤第2天,骨折合并脊髓损伤组与骨折无脊髓损伤组血清转化生长因子β1水平差异无显著性意义(P>0.05),在第7,14,28天,骨折合并脊髓损伤组比骨折无脊髓损伤组血清转化生长因子β1水平低(P<0.05)。在骨折合并脊髓损伤组中,血清转化生长因子β1水平从第7天快速升高,至第14天达到高峰,第28天仍然无显著下降。在骨折无脊髓损伤组,第2天升高,第7天升高幅度达到最大,至第28天,升高幅度下降。骨折合并脊髓损伤组血清中转化生长因子β1可发生显著变化,可能与转化生长因子β1在不同时期参与骨折愈合及脊髓损伤修复有关。

BACKGROUND： Studies have shown that transforming growth factor beta 1 plays an important role in the healing of fractures, but in spinal cord injury combined with fracture, transforming growth factor beta 1 has been never reported how to promote fracture healing. OBJECTIVE： To observe the changes of serum transforming growth factor beta 1 levels in patients with spinal cord injury combined with bone fractures and to discuss the mechanism of transforming growth factor beta 1 in fracture healing after spinal cord injury with bone fractures. METHODS： Totally 28 patients admitted at the Department of Spinal Surgery, the First Affiliated Hospital of Xinjiang Medical University from May 2012 to March 2014 were collected and divided into two groups according to whether they suffered from spinal cord injury： fracture＋spinal cord injury group （n=12） and simple fracture group （n=16）. Fasting peripheral blood samples were collected from patients in the two groups at 2, 7, 14, 28 days after injury, and ELISA method was used to detect the level of serum transforming growth factor beta 1. RESULTS AND CONCLUSION： There was no significant difference in the level of serum transforming growth factor beta 1 between the two groups at 2 days after injury （P 〉 0.05）, but the levels of serum transforming growth factor beta 1 in the fracture＋spinal cord injury group were lower than those in the simple fracture group at 7, 14,28 days after injury （P 〈 0.05）. In the fracture＋spinal cord injury group, the level of serum transforming growth factor beta 1 had a rapid increase on the 7th day, and reached the peak on the 14^th day, and then, this level had no significant decrease until the 28th day. In the simple fracture group, the level of serum transforming growth factor beta 1 began to increase on the 2^nd day, reached the peak on the 7^th day, and then decreased gradually. Remarkable changes of serum transforming growth factor beta 1 levels in patients with bone fracture combined with spinal cord injury may be associated with fracture healing in different periods.