骨肽注射液联合高压氧对胫骨骨折的临床疗效及对骨性标志物水平与关节功能的影响

Clinical Effectiveness of Ossotide Injection Combined with Hyperbaric Oxygen in Patients with Tibial Fractures and Its Effects on Bone Marker Levels and Joint Function

目的探讨骨肽注射液联合高压氧对胫骨骨折疗效及骨性标志物水平与关节功能的影响。方法选择2014年10月—2016年6月西安交通大学医学院附属三二○一医院骨科收治的胫骨骨折并接受切开复位内固定术者84例,按术后治疗方法分为观察组和对照组,每组42例。对照组给予骨肽注射液,观察组给予骨肽注射液联合高压氧治疗。比较两组治疗后临床疗效;治疗前、后血清骨性标志物水平及踝关节功能评分。结果观察组治疗有效率高于对照组(P<0.05);两组术后1个月,骨碱性磷酸酶与血清碱性磷酸酶比值、骨钙素、Ⅰ型前胶原羧基端肽、降钙素含量明显高于手术前,且观察组高于对照组(P<0.05),Ⅰ型胶原羧基端肽β特殊序列、总骨Ⅰ型前胶原氨基端延长肽的含量低于手术前,且观察组低于对照组(P<0.05);治疗后3、6个月两组踝关节评分均明显提高,且观察组高于对照组(P<0.05)。结论骨肽注射液联合高压氧治疗胫骨骨折效果显著,能明显调节骨性标志物水平,促进骨形成及骨折愈合,改善患肢关节功能,值得临床推广运用。

Objective To investigate clinical effectiveness of Ossotide Injection combined with hyperbaric oxygen in patients with tibial fractures and its effects on bone marker levels and joint function. Methods A total of 84 patients with tibial fractures,who had undergone open reduction and internal fixation during October 2014 and June 2016,were divided into observation group（ n = 42） and control group（ n = 42） according to postoperative therapeutic methods.All patients were treated with Ossotide Injection,while observation group was treated with Ossotide Injection combined with hyperbaric oxygen treatment. In two groups,clinical effectiveness,serum levels of bone markers and scores of ankle joint function before and after treatment were compared. Results Effective rate in observation group was significantly higher than that in control group（ P〈0. 05）. In 1 month after operation,in observation group,values of bone alkaline phosphatase/alkaline phosphatase,contents of bone gla protein,type Ⅰ procollagen carboxyl telopeptide and calcitonin were significantly higher（ P〈0. 05）,while type Ⅰ collagen carboxyl telopeptide β special subsequence and total typeⅠ procollagen amino terminal prolonging peptide contents were significantly lower than those in control group（ P〈0. 05）. In 3 and 6 months after treatment,scores of ankle joint function were significantly higher in the two groups,and the scores in observation group were significantly higher than those in control group（ P〈0. 05）. Conclusion Ossotide Injection combined with hyperbaric oxygen in treatment of patients with tibial fractures has good effectiveness,and it may significantly adjust levels of bone markers,promote bone formation and fracture healing and improve joint function of affected limbs.