ALP和r-GGT及hs-CRP对中老年股骨粗隆骨折术后预后的评估价值研究

The value of ALP,r-GGT and hs-CRP in evaluating the prognosis of middle-aged and elderly patients with femoral trochanteric fracture

目的探讨碱性磷酸酶(ALP)、r-谷氨酰转肽酶(r-GGT)和超敏C反应蛋白(hs-CRP)对中老年股骨粗隆骨折术后预后的评估价值。方法选取2019年7月至2020年6月在本院行手术治疗的中老年股骨粗隆骨折患者40例为观察组(术后合并感染16例,未合并感染24例),40例非骨折健康体检者为对照组。比较不同组别、观察组术后合并感染与未合并感染者hs-CRP、r-GGT、ALP水平差异,并分析中老年股骨粗隆骨折术前与术后不同时间点hs-CRP、r-GGT、ALP变化情况、术后1个月时hs-CRP、r-GGT、ALP水平降低与Harrir髋关节功能累积优良率关系。结果观察组hs-CRP、r-GGT、ALP水平均高于对照组,差异有统计学意义(P<0.05);合并感染组hs-CRP、r-GGT、ALP水平明显高于未合并感染组,差异有统计学意义(P<0.05);以术前检测结果为基数,术后3 d时hs-CRP、r-GGT、ALP水平明显升高,7 d和1个月时hs-CRP、r-GGT、ALP水平均存在不同程度降低,差异有统计学意义(P<0.05);Kaplan-Meier分析显示,术后1个月时,hs-CRP、r-GGT、ALP降低幅度较高组Harrir髋关节功能累积优良率高于降低幅度较低组,差异有统计学意义(P<0.05)。结论中老年股骨粗隆骨折患者体内血清hs-CRP、rGGT、ALP水平明显升高,监测3项指标利于了解患者术后病情变化情况和预后。

Objective To evaluate the value of alkaline phosphatase(ALP),r-glutamyltranspeptidase(r-GGT)and high-sensitivity C-reactive protein(hs-CRP)in evaluating the prognosis of middle-aged and elderly patients with femoral trochanteric fractures.Methods 40 patients with middle-aged and elderly patients with femoral trochanteric fractures who underwent surgery in our hospital from July 2019 to June 2020 were enrolled in the study group(16 patients with postoperative infection,24 patients without infection)and 40 healthy persons were selected as control group.The levelsof hs-CRP,r-GGT and ALP between the patients with and without infection in the observation groupwere compared and the levels between control group and observation group were compared.The changes of hs-CRP,r-GGT and ALP at different time points before and after operation,and the relationship between the decrease of hs-CRP,r-GGT and ALP levels and the cumulative excellent and good rate of Harrir hip function at 1 month after operation were analyzed.Results The levels of hs-CRP,r-GGT and ALP in the observation group were higher than the control group,with significant difference(P<0.05).The levels of hs-CRP,r-GGT and ALP in the infected group were significantly higher than those in the uninfected group(P<0.05).Based on the preoperative test results,the levels of hs-CRP,r-GGT and ALP were significantly increased at 3 days after operation,and the levels of hs-CRP,r-GGT and ALP were significantly decreased at 7 days and 1 month(P<0.05).Kaplan-Meier analysis showed that the excellent rate of hip function in Harrir group was higher than that in the group with lower reduction of hs-CRP,r-GGT and ALP at 1 month after operation,and the difference was statistically significant(P<0.05).Conclusion The serum levels of hs-CRP,r-GGT and ALP in middle-aged and elderly patients with femoral trochanteric fracture were significantly increased.Monitoring the three indicators is helpful to understand the changes and prognosis of patients after operation.