骨折延迟愈合患者血清TGF-β1、BMP-2、ALP及血液流变学指标研究

Study of serum TGF-β1,BMP-2,ALP and hemorheology indicators in patients with delayed fracture healing

目的探讨骨折延迟愈合患者血转化生长因子-β1(transforming growth factor,TGF-β1)、骨形态发生蛋白-2(Bone morphogenetic protein-2,BMP-2)、碱性磷酸酶(Alkaline phosphatase,ALP)及血液流变学指标变化。方法:选取67例骨折延迟愈合患者(观察组)和67例骨折正常愈合患者(对照组)为研究对象,比较两组患者年龄、性别构成、骨折严重情况、骨折固定、感染及患者功能活动情况。检测两组患者骨折后12周血浆黏度、红细胞聚集指数、红细胞刚性指数、全血黏度及血清TGF-β1、BMP-2、ALP水平,并进行对比分析。结果 :观察组中60岁以上患者43例(64.18%),严重骨折41例(61.19%),内固定不稳9例(13.43%),感染11例(16.42%),功能活动不合理15例(19.40%),各项指标发生比例均大于对照组(P<0.05)。观察组各血液流变学指标均明显高于对照组,差异具有显著性(P<0.05)。观察组患者血清TGF-β1、BMP-2、ALP水平均明显低于对照组患者,差异具有显著性(P<0.05)。结论:骨折延迟愈合与患者年龄、骨折严重程度、内固定、感染以及功能活动情况有关,且患者血清TGF-β1、BMP-2、ALP明显降低,血液微循环状态也较差。

Objective To investigate the change of transforming growth factor（TGF-β1）,bone morphogenetic protein-2（BMP-2）,alkaline phosphatase（ALK） and hemorheology indicators in patients with delayed fracture healing. Methods Sixth-seven patients with delayed fracture healing（observation group） and 67 patients with normal fracture healing（control group） were enrolled in this study. The age,gender composition,severity of fracture,stability of fixation,infection and functional activity were compared in two groups. The plasma viscosity,erythero-cystic agglutination index,blood viscosity,erythrocyte rigidity index and serum TGF-β1,BMP-2,ALP level were detected and analyzed 12 weeks after fracture in two groups. Results 43 patients were older than 60（64.18%） in observation group and 41 patients with severe fracture（61.19%）,9 patients with internal fixation of unstable（13.43%）,11 patients with infection（16.42%）,15 patients with unreasonable function activities（19.40%）. Those occurrence rates in observation group were significantly higher than control group（P〈0.05）. The indexes of hemorheology in observation group were significantly higher than control group（P〈0.05）. The serum TGF-β1,BMP-2,ALP level in observation group were significantly lower than control group（P〈0.05）. Conclusion The delayed fracture healing is associated with age,severe fracture,fixation instability,infection and functional activities. The serum TGF-β1,BMP-2,ALP level decrease and with worse microcirculation in patients with delayed fracture healing.