股骨颈骨折术后患者血清1型纤溶酶原激活物抑制剂、内皮素-1水平表达及与股骨头坏死发生的关系

The expression of serum type 1 plasminogen activator inhibitor and endothelin-1 in patients with femoral neck fracture after operation and their relationship with femoral head necrosis

目的 观察血清1型纤溶酶原激活物抑制剂(PAI-1)、内皮素-1(ET-1)水平在股骨颈骨折术后患者中的表达情况,并分析上述血清指标与股骨头坏死发生的关系。方法 纳入2014年4月—2021年6月在浙江省湖州市福音医院行手术治疗的96例股骨颈骨折患者作为研究对象,所有患者均在术后1 d测定血清PAI-1、ET-1水平,并以门诊复诊方式随访1年,统计随访期间患者股骨头坏死发生情况,将发生股骨头坏死的患者纳入病例组,反之纳入常规组,并采用SPSS 25.0软件分析股骨颈骨折术后患者血清PAI-1、ET-1水平表达与股骨头坏死发生的关系。结果 随访1年,96例股骨颈骨折术后患者中共有19例发生股骨头坏死,发生率为19.79%;病例组血清PAI-1、ET-1水平高于常规组,差异有统计学意义(P<0.05);经点二列相关分析证实,股骨颈骨折术后患者血清PAI-1、ET-1水平与股骨头坏死发生成正相关(r值分别为0.526、0.559,P<0.05);经多项logistic回归分析,结果显示,血清PAI-1、ET-1水平升高是股骨颈骨折术后患者股骨头坏死发生的危险因素(P<0.05)。结论 股骨颈骨折术后患者血清PAI-1、ET-1水平表达异常与股骨头坏死有关,且血清PAI-1、ET-1水平升高是患者术后股骨头坏死发生的危险因素。

Objective This paper aims to observe the expression of serum type 1 plasminogen activator inhibitor(PAI-1) and endothelin-1(ET-1) in patients with femoral neck fracture after operation, and analyze the relationship between the above serum indexes and the occurrence of femoral head necrosis. Methods 96 patients with femoral neck fracture who underwent surgical treatment in Huzhou Gospel Hospital of Zhejiang Province from April 2014 to June 2021 were included as the study subjects. The serum levels of PAI-1 and ET-1 were measured in all patients on the first day after operation, and the patients were followed up for 1 year by outpatient follow-up. The incidence of femoral head necrosis was counted during the follow-up. Patients with femoral head necrosis were included in the case group, otherwise included in the conventional group. The relationship between the expression of serum PAI-1 and ET-1 and the occurrence of femoral head necrosis was analyzed by SPSS 25.0 data processing software. Results Follow-up for 1 year showed that there were 19 cases of femoral head necrosis(19.79%) in 96 patients with femoral neck fracture after operation. The levels of serum PAI-1 and ET-1 in the case group were higher than those in the conventional group, with the differences statistically significant(P<0.05). Point binary correlation analysis confirmed that the serum PAI-1 and ET-1 levels in patients with femoral neck fracture after operation were positively correlated with the occurrence of femoral head necrosis(r=0.526, r=0.559, P<0.05). Through multiple logistic regression analysis, the results showed that the increased levels of serum PAI-1 and ET-1 were the risk factors of femoral head necrosis in patients with femoral neck fracture after operation(P<0.05). Conclusion The abnormal expression of serum PAI-1 and ET-1 in patients with femoral neck fracture after operation is related to femoral head necrosis, and the increase of serum PAI-1 and ET-1 is a risk factor for the occurrence of femoral head necrosis after operation.