骨生化标志物的动态检测在预测下肢长骨骨折延迟愈合的临床意义

Clinical Significance of Bone Biochemical Markers Dynamic Testing in Predicting the Delayed Union of Long Bone Fracture of Lower Limbs

目的探讨骨生化标志物的动态检测在预测下肢长骨骨折延迟愈合的临床意义。方法选取我院2013年10月至2015年8月的下肢长骨骨折手术治疗病例60例,平均分为两组。其中延迟组为延迟愈合,愈合组为正常愈合,分别于伤后24小时内、术后1周及术后第4、8、12周检测静脉血BAP、OC、CTX及尿液DPD含量。结果 1两组在性别、年龄、体重、骨折部位、骨折类型、受伤机制等方面比较无统计学意义(P>0.05);2术后第8、12周,延迟组OC含量(ng/m L)分别为25.15±4.10、28.33±3.92,高于同时期愈合组的22.20±4.06、23.73±4.25,组间比较有统计学意义(P<0.05);延迟组CTX含量(ng/m L)分别为0.74±0.16、0.42±0.14,高于同时期愈合组的0.66±0.14、0.27±0.11,组间比较有统计学意义(P<0.05);3术后第12周,延迟组BAP、OC、CTX及DPD比值均高于愈合组(P<0.05)。结论骨折术后骨生化标志物均有增加,延迟组第12周OC及CTX明显增加,术后12周OC及CTX的检测可初步预测骨折延迟愈合是否发生。

Objective To explore the clinical significance of bone biochemical markers dynamic testing in predicting the delayed union of long bone fracture of lower limbs. Methods 60 cases of patients received internal fixation of long bone fracture of lower limbs from October 2013 to August 2015 in our hospital were divided into delayed union group and normal healing group equally. The BAP, OC, CTX in venous blood and DPD in urine of all patients were tested separately in 24 hours after injury, and the 1st, 4th, 8th, 12th week after surgery. Results （1）No statistical difference was found in gender, age, weight, fracture position, fracture type and injury mechanism between two groups （P〉0.05）.The OC content at the 8th and 12thweek after surgery of delayed union group were （25.15 ± 4.10） ng/mL and （28.33 ± 3.92） ng/mL, higher than （22.20 ± 4.06） ng/mL and （23.73 ± 4.25） ng/mL of normal healing group in the same period of time （P〈0.05）. The CTX content at the 8th and 12th week after surgery of delayed union group were （0.74 ±0.16） ng/mL and （0.42 ±0.14） ng/mL, higher than （0.66± 0.14） ng/mL and （0.27±0.11） ng/mL of normal healing group in the same period of time （P 〈0.05）. The ratio of BAP, OC, CTX and DPD at 124 week after surgery in delayed union group were higher than those of normal healing group （P〈0.05）. Conclusions All the bone biochemical markers increase after surgey, and the OC and CTX at 12th week in the delayed group increase significantly. The detection of CTX and OC at 12th week after surgey can preliminarily predict the occurrence of delayed union of fracture.