老年女性桡骨远端骨折患者的骨代谢指标检测分析及再发骨折的危险因素探讨

Detection and analysis of bone metabolic indexes in elderly female patients with distal radius fractures and discussion of risk factors for recurrent fractures

目的探讨老年女性桡骨远端骨折患者的骨代谢指标检测分析及再发骨折的危险因素。方法选择石家庄市第三医院2017年2月~2018年10月收治的182例老年女性桡骨远端骨折患者的资料进行回顾性分析,入院后均检测骨代谢指标,统计再发骨折的情况并分析其危险因素。结果患者血清碱性磷酸酶(ALP)、骨钙素(BGP)、Ⅰ型胶原N末端肽(NTX-Ⅰ)水平分别为(37.56±5.83)U/L、(3.89±1.05)μg/L、(38.47±5.56)nmol/L;再发骨折的发生率为18.68%,高龄、体重指数(BMI)<18 kg/m2、BMI>25 kg/m2、伴2型糖尿病、伴骨质疏松症、伴下肢关节病、血清ALP<40 U/L、血清BGP<4.8μg/L、血清NTX-Ⅰ>20 mmol/L、独居均为再发骨折的独立危险因素(OR=5.512、6.265、5.697、6.659、7.776、6.062、7.367、6.699、6.966、7.135,P<0.05);植骨、早期负荷锻炼、服用钙盐均为再发骨折的独立保护因素(OR=0.511、0.457、0.475,P<0.05)。结论老年女性桡骨远端骨折患者多伴有骨代谢异常,且高龄等均可增加再发骨折的风险,骨代谢异常均是其独立危险因素,植骨等则是其保护因素。

Objective To investigate the bone metabolism of elderly female patients with distal radius fracture and the risk factors of recurrent fracture.Methods From February 2017 to October 2018,retrospective analysis was conducted on the data of 182 elderly female patients with distal radius fracture admitted to Shijiazhuang No.3 Hospital.Bone metabolism indexes were detected after admission.The risk factors of recurrent fracture were analyzed.Results Patients with serum alkaline phosphatase(ALP),bone gta-protein(BGP),collagen typeⅠN terminal peptide(NTX-Ⅰ)level were(37.56±5.83)U/L,(3.89±1.05)μg/L,(38.47±5.56)nmol/L,respectively.The incidence recurrent hair fracture was 18.68%,older age,body mass index(BMI)<18 kg/m2,BMI>25 kg/m2,with type 2 diabetes,osteoporosis,with lower limb joint disease,serum ALP<40 U/L,serum BGP<4.8μg/L,serum NTX-Ⅰ>20 mmol/L,live alone are independent risk factors for recurrence of bone(OR=5.512,6.265,5.697,6.659,7.776,6.062,7.367,6.699,6.966,7.135,P<0.05).Bone grafting,early load exercise,and calcium salt use were all independent protective factors for recurrent fractures(OR=0.511,0.457,0.475,P<0.05).Conclusion Elderly women with distal radius fracture are often accompanied by abnormal bone metabolism,and advanced age can increase the risk of recurrent fracture.Abnormal bone metabolism is an independent risk factor,while bone grafting is a protective factor.