髋关节置换辅助维生素D治疗老年骨质疏松股骨颈骨折的远期疗效及对BMP-7/25-(OH)-D-3水平的影响

The long-term effect of hip replacement and vitamin D in the treatment of elderly osteoporotic femoral neck fractures and its effect on the level of BMP-7/25-(OH)-D-3

目的探究髋关节置换辅助维生素D治疗老年骨质疏松股骨颈骨折的远期疗效及对转染骨形态发生蛋白-7(BMP-7)/25羟基维生素D3[25-(OH)-D3]水平的影响。方法选取2018年1月至2020年1月期间杭州萧山区中医骨伤科医院骨科住院的老年骨质疏松股骨颈骨折患者108例,按照随机数字表法分为治疗组(髋关节置换辅助维生素D治疗)和对照组(髋关节置换治疗),每组54例。对所有受试者进行为期一年的有效随访,观察两组患者远期治疗疗效及SF-36评分,同时分别于治疗前及治疗后1、3、6、12个月,比较两组患者腰椎及髋关节骨密度、髋关节Harris评分、BMP-7、25-(OH)-D3水平变化的差异。结果治疗后12个月,治疗组远期治疗疗效显著高于对照组(P<0.05);治疗后1、3、6、12个月,两组患者的腰椎及髋关节骨密度、SF-36评分、髋关节Harris评分、BMP-7、25-(OH)-D3水平随着时间的推移,上升程度不相等,但以治疗组的改善程度最大(P<0.01)。结论髋关节置换辅助维生素D治疗老年骨质疏松股骨颈骨折具有良好的远期疗效,能明显提高骨密度,改善BMP-7和25-(OH)-D3水平。

Objective To explore the long-term effect of hip replacement and vitamin D in treatment of elderly osteoporotic femoral neck fractures and the transfection of bone morphogenetic protein-7(BMP-7)/25 hydroxy vitamin D3[(25-(OH))-D3]level.Method Data of 108 elderly osteoporotic femoral neck fracture patients admitted from Jan.2018 to Jan.2020 were selected,and they were divided them into the observation group(hip replacement adjuvant vitamin D treatment)and control group(hip replacement treatment),54 cases in each group.All subjects were followed up for 1 year to observe the long-term treatment efficacy and SF-36 scores of the two groups of patients.Before treatment and 1,3,6,and 12 months after treatment,the differences in the changes in lumbar and hip bone mineral density,hip joint Harris score,BMP-7,and 25-(OH)-D3 levels were compared between the two groups.Results 12 months after treatment,the long-term treatment effect of the observation group was significantly higher than that of the control group(P<0.05);1,3,6,12 months after treatment,for the lumbar and hip bone mineral density,SF-36 score,hip Harris score,BMP-7,25-(OH)-D3 levels of the two groups of patients over time,the degree of increase was not equal,but the treatment group had the greater degree of improvement(P<0.01).Conclusion Hip joint replacement and vitamin D have a good long-term effect in treatment of elderly osteoporotic femoral neck fractures,which can significantly increase bone density and improve BMP-7 and 25-(OH)-D3 levels.