膝关节骨关节炎患者单髁置换术前血脂水平与术后功能活动的相关性

Correlation between blood lipid level before unicondylar replacement and functional activity after operation in patients with knee osteoarthritis

目的观察行单髁置换术的膝关节骨关节炎(KOA)患者术前血脂水平及其与术后功能活动的相关性。方法回顾性分析2017年6月—2019年6月新疆医科大学附属中医医院骨二科(关节外科)单髁置换术治疗KOA患者84例临床资料;随访6个月,采用美国纽约特殊外科医院膝关节功能量表(HSS)评估患者膝关节功能活动情况,分为恢复优良组(优、良)59例,恢复不良组(中、差)25例;分析术前血脂水平与术后功能活动的相关性。结果KOA患者84例术后功能活动恢复优、良、中、差分别为26例、33例、20例、5例;恢复不良组术前TC、TG、LDL-C水平均高于恢复优良组,HDL-C水平低于恢复优良组(t/P=3.377/0.001、4.782/0.000、4.962/0.000、2.774/0.007);KOA患者功能活动恢复(HSS评分)与术前HDL-C水平呈正相关(r=0.710,P=0.000),与TC、TG、LDL-C水平呈负相关(r=-0.478、-0.460、-0.768,P均=0.000);术前TC、TG、LDL-C水平升高,HDL-C水平降低是KOA患者术后功能活动恢复不良的影响因素[OR(95%CI)=4.987(2.215~11.227)、16.304(3.589~74.056)、423.158(28.981~6178.636)、415.569(25.697~6054.697)];TC、TG、HDL-C、LDL-C用于预测KOA患者术后膝关节功能活动恢复不良风险的曲线下面积分别为0.791、0.751、0.934、0.960,且HDL-C、LDL-C的预测价值更好。结论KOA患者单髁置换术前血脂水平对术后功能活动的恢复有一定影响,可用于预测KOA患者术后功能活动恢复不良风险,对早期风险预测与干预指导有积极意义。

Objective To observe the preoperative blood lipid level and its correlation with postoperative functional activities in patients with knee osteoarthritis(KOA)undergoing unicondylar replacement.Methods A retrospective analysis of the clinical data of 84 patients with KOA treated by unicondylar replacement in the Second Department of Orthopedics(Joint Surgery)of the Affiliated Chinese Medicine Hospital of Xinjiang Medical University from June 2017 to June 2019;follow-up for 6 months,using the New York Special Surgery Hospital(HSS)Knee joint function scoring assesses the functional activities of the knee joints of patients,and is divided into an excellent recovery group(excellent and good)with 59 cases and a poor recovery group(moderate and poor)with 25 cases;analysis of the correlation between preoperative blood lipid levels and postoperative functional activities.Results The functional recovery of 84 patients with KOA after operation was excellent,good,moderate,and poor,respectively,26,33,20,and 5 respectively.The preoperative TC,TG,LDL-C levels of the poor recovery group were higher than those of the good recovery group,and HDL-C The C level was lower than that of the excellent recovery group(t/P=3.377/0.001,4.772/0.000,4.962/0.000,2.774/0.007).The functional recovery of KOA patients(HSS score)was positively correlated with the preoperative HDL-C level(r=0.710,P=0.000),negatively correlated with TC,TG,LDL-C levels(r=-0.478,-0.460,-0.768,P=0.000).Before surgery,TC,TG,LDL-C levels increased,HDL-C levels Decrease is the influencing factor of poor functional activity recovery in KOA patients[OR(95%CI)=4.987(2.215~11.227),16.304(3.589~74.056),423.158(28.981~6178.636),415.569(25.697~6054.697)].The area under the curve of TC,TG,HDL-C,and LDL-C for predicting the risk of poor recovery of knee joint function in KOA patients are 0.791,0.751,0.934,0.960,respectively,and HDL-C and LDL-C have better predictive value.Conclusion The blood lipid level before unicondylar replacement in KOA patients has a certain impact on the recovery of postoperative functional activities,which can be used to predict the risk of poor functional recovery after surgery in KOA patients,and has positive significance for early risk prediction and intervention guidance.