骨钙素、骨特异性碱性磷酸酶、胰岛素样生长因子1水平对胫骨骨折患者术后骨折愈合情况的预测价值分析

Analysis of predictive value of Osteocalcin, bone-specific alkaline phosphatase and the levels of insulin-like growth factor 1 on fibial fracture healing

[目的]分析骨钙素(BGP)、骨特异性碱性磷酸酶(BAP)、胰岛素样生长因子1(IGF-1)水平对胫骨骨折患者术后骨折愈合情况的预测价值。[方法]选取我院2017年10月至2018年11月期间行髓内固定术的80例胫骨骨折患者的病例资料,术后进行为期12个月的随访,依据患者术后骨折愈合情况分为非正常愈合组15例(18.75%)与正常愈合组65例(81.25%)。比较2组患者术后1周血清中BGP、BAP、IGF-1间水平的差异并绘制ROC曲线进行评估。[结果]非正常愈合组术后1周血清BGP、BAP、IGF-1水平分别为[5.10(3.86,6.23)]μg/L、[89.35(76.39,102.41)]U/L、[334.72(314.20,365.24)]ng/mL,均低于正常愈合组的[5.69(4.55,6.98)]μg/L、[112.38(97.31,127.45)]U/L、[364.17(320.66,407.68)]ng/mL(P<0.05);BGP、BAP、IGF-1以及联合预测曲线下面积(AUC)值分别为0.782、0.881、0.841、0.912,均大于参考线,差异有统计学意义(P<0.05)。[结论]血清BGP、BAP、IGF-1水平对术后骨折愈合情况具有较高的预测价值,联合检测可作为早期判断术后非正常愈合的参考依据,值得临床应用。

[Objective]To analyze the predictive value of osteocalcin(BGP),bone specific alkaline phosphatase(BAP)and insulin-like growth factor 1(IGF-1)levels on postoperative fracture healing in patients with tibial fractures.[Methods]data of 80 patients with tibial fractures who underwent intramedullary fixation in our hospital from October 2017 to November 2018 were selected.All 80 patients were followed up for 12 months.According to the postoperative fracture healing status of the patients,15(18.75%)in the abnormal healing group and 65(81.25%)in the normal healing group were divided into two groups.Differences in serum levels of BGP,BAP and IGF-1 between the two groups were compared one week after surgery and ROC curve was plotted for evaluation.[Results]Serum levels of BGP,BAP and IGF-1 in the abnormal healing group were[5.10(3.86,6.23)]g/L,[89.35(76.39,102.41)]U/L,[334.72(314.20,365.24)]ng/mL,respectively,lower than those in the normal healing group[5.69(97.31,127.45)]U/L,[364.17(320.66,407.68)]ng/mL(P<0.05).The values of BGP,BAP,IGF-1 and AUC were 0.782,0.881,0.841 and 0.912,respectively,which were greater than the reference line(P<0.05).[Conclusion]serum levels of BGP,BAP and IGF-1 have a high predictive value for postoperative tibid fracture healing.