创伤性骨折后应激水平与凝血功能及骨折愈合进度的相关性

Correlation between stress level after traumatic fracture and coagulation function and fracture healing progress

目的观察创伤性骨折患者在骨折后的应激水平和患者凝血功能指标及骨折愈合评分的相关性。方法选择2014年1月~2016年12月本院收治的创伤性骨折患者共48例为观察组,纳入同期正常体检人员48例为对照组,观察两组受试者的一般情况、氧化应激指标:超氧化物歧化酶(SOD)和丙二醛(MDA)及凝血功能指标:血浆纤维蛋白原定量(Fib)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT);采用Spearman相关性分析观察组的应激水平与凝血功能指标的相关性,应激水平与患者骨折愈合进度的相关性。结果两组受试者的性别及平均年龄对比差异无统计学意义,两组受试者的氧化应激指标(SOD和MDA)、凝血功能指标(Fib)对比具有统计学意义(P<0.05),两组受试者的凝血功能指标(APTT、TT、PT)对比差异无统计学意义;SOD与Fib、MDA与Fib分别呈现负相关及正相关(P<0.05),应激指标与其余凝血功能指标经检验无相关性(P>0.05);观察组术后3个月在骨折愈合评分为(7.46±1.34)分,经Spearman相关性分析表明SOD与骨折愈合评分呈现正相关(P<0.05),与MDA呈现负相关(P<0.05)。结论创伤性骨折能引起应激反应,应激反应与凝血功能指标(Fib)及骨折愈合进度具有一定的相关性。

Objective To observe the correlation between the stress level in patients with traumatic fracture after fracture and the coagulation function index and fracture healing score. Methods Forty-eight patients with traumatic fracture treated in our hospital from January 2014 to December 2016 were selected as the observation group. Forty-eight normal subjects were enrolled as the control group during the same period from January 2014 to December 2016. The general conditions of the two groups were observed and the indexes of oxidative stress （SOD）, malondialdehyde （MDA） and indexes of coagulation： Fib, APTT, TT, PT; Spearman correlation analysis was used to analyze the relationship between stress level and coagulation function in the observation group Sex, stress level and the progress of patients with fracture healing. Results There was no significant difference in gender and average age between the two groups. The oxidative stress index （SOD and MDA） and coagulation index （Fib） of the two groups had statistical significance （P 〈0.05）. There was no significant difference in coagulation function index （APTT, TT, PT） between the two groups of subjects; the correlation between SOD and Fib, MDA and Fib was negative correlation and positive correlation respectively（P〉0.05）. The fracture healing score in the observation group was （7.46 ± 1.34） at 3 months after operation. Spearman correlation analysis showed that there was a positive correlation between SOD and fracture healing score （P 〈0.05）, But negatively correlated with MDA （P 〈0.05）. Conclusion Traumatic fractures can cause stress response, stress response and coagulation function index （Fib） and fracture healing progress has some relevance.