PA、TGF-β1及ACTH在创伤性骨折中的表达及临床意义

Expression and clinical significance of PA,TGF-β1 and ACTH in traumatic fractures

目的探讨血清前白蛋白(PA)、转化生长因子(TGF-β1)及应激激素促肾上腺皮质激素(ACTH)在创伤性骨折中的表达及临床意义。方法选取2017年5月至2019年5月在本院进行治疗的114例创伤性骨折患者设为观察组(其中轻度组60例,重度组54例),选取本院同期118例健康体检者设为对照组,对比不同人群血清PA、TGF-β1、ACTH水平。随访6个月,计算观察组下肢深静脉栓塞发生率,logistic分析影响患者发生下肢深静脉栓塞分相关危险因素。结果观察组患者PA显著低于对照组,TGF-β1、ACTH水平均显著高于对照组,差异均有统计学意义(P<0.05)。重度组患者PA水平明显低于轻度组,TGF-β1、ACTH水平均显著高于轻度组,差异均有统计学意义(P<0.05)。有16.67%(19/114)的患者发生下肢深静脉栓塞,PA(低表达)、TGF-β1(高表达)、ACTH(高表达)的创伤性骨折患者发生下肢深静脉栓塞率更高(P<0.05)。合并高血压、糖尿病、高血脂疾病、受伤原因(高能量)、骨折严重程度(重度)、PA(低表达)、TGF-β1(高表达)、ACTH(高表达)为影响创伤性骨折患者发生下肢深静脉栓塞的独立危险因素(P<0.05)。结论PA、TGF-β1、ACTH三者可作为检测创伤性骨折患者发生下肢深静脉栓塞的敏感性指标。

Objective To explore the expression and clinical significance of serum prealbumin(PA),transforming growth factor-β1(TGF-β1)and stress hormone adrenocorticotropic hormone(ACTH)in traumatic fractures.Methods 114 patients with traumatic fractures treated in this hospital from May 2017 to May 2019 were selected as the observation group(including 60 cases in the mild group and 54 cases in severe group),and 118 people with healthy physical examination in the hospital during the same period were selected as a control group.The levels of serum PA,TGF-β1,and ACTH in different groups were compared.All patients were followed up for 6 months to calculate the incidence of deep venous thrombosis of the lower extremities of patients in the observation group.Logistic analysis was used to analyze the risk factors that affect deep vein thrombosis of the lower extremities of patients.Results The PA level of patients in the observation group was significantly lower than that in the control group,and the levels of TGF-β1 and ACTH were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The PA level of patients in the severe group was significantly lower than that in the mild group,and the levels of TGF-β1 and ACTH were significantly higher than those in the mild group,and the differences were statistically significant(P<0.05).16.67%(19/114)patients with a lower extremity deep venous thrombosis and patients with traumatic fractures and PA(low expression),TGF-β1(high expression)and ACTH(high expression)had a higher rate of deep venous embolism(P<0.05).Combined with hypertension,diabetes,hyperlipidemia,cause of injury(high energy),fracture severity(severe),PA(low expression),TGF-β1(high expression),ACTH(high expression)are independent risk factors for deep vein thrombosis in patients with traumatic fractures(P<0.05).Conclusion PA,TGF-β1 and ACTH are can be used as sensitive indicators to detect deep vein thrombosis in patients with traumatic fractures.