营养状况、骨代谢及股骨颈强度指数和骨髓脂质分数与老年髋部骨折术后关节功能恢复的关系研究

Study on the Relationship between Nutritional Status,Bone Metabolism,Femoral Neck Strength Index,Bone Marrow Lipid Fraction,and Postoperative Joint Function Recovery in Elderly Patients after Hip Fractures

目的探究营养状况、骨代谢及股骨颈强度指数(FSI)和骨髓脂质分数(LF)与老年髋部骨折术后关节功能恢复的关系。方法选取2021年6月至2023年6月于原阳县中心医院接受治疗的髋部骨折手术老年患者160例为研究对象。根据患者髋关节功能恢复情况进行分组,恢复良好患者87例纳入良好组,恢复不良患者73例纳入不良组。对比两组患者一般资料、营养状况、骨代谢及FSI和LF。结果良好组年龄≥75岁比例、体重、体质量指数(BMI)、股骨粗隆间骨折比例、Ⅰ型胶原蛋白N端肽(NTX)、抗酒石酸酸性磷酸酶5b(TPACP-5b)水平表达均低于不良组,差异均有统计学意义(P<0.05);良好组微型营养评定(MNA)评分、FSI、LF、骨钙蛋白(BGP)水平表达均高于不良组,差异均有统计学意义(P<0.05);经Logistic回归分析,MNA评分、LF、FSI、NTX、TPACP-5b、BGP水平表达均为影响老年髋部骨折术后关节功能恢复情况的独立危险因素,差异有统计学意义(P<0.05);经受试者工作特征(ROC)曲线分析,MNA评分、FSI、LF、NTX、TPACP-5b水平表达均对老年髋部骨折术后关节功能恢复情况有较高的预测价值,曲线下面积(AUC)值分别为0.936、0.874、0.866、0.884、0.825;BGP水平表达的AUC值为0.634,可作为次要参考。结论观察行髋部骨折手术的老年患者术后营养状况、骨代谢及股骨颈强度指数和骨髓脂质分数的变化情况,有利于早期预测患者术后髋关节功能恢复情况,从而制定相应防控措施,帮助患者早日康复。

Objective Explore the relationship between nutritional status,bone metabolism,femoral neck strength index(FSI),bone marrow lipid fraction(LF),and postoperative joint function recovery in elderly patients after hip fractures.Methods A retrospective study was conducted on 160 elderly patients who underwent hip fracture surgery in Central Hospital of Yuanyang County from June 2021 to June 2023.According to the recovery of hip joint function in patients,87 patients with good recovery were included in the good recovery group,while 73 patients with poor recovery were included in the poor recovery group.The general information,nutritional status,bone metabolism,FSI and LF were compared between the two groups.Results The proportion of age≥75 years,body weight,body mass index(BMI),proportion of intertrochanteric fractures,levels of N-terminal cross-linked telopeptide of type I collagen(NTX),tartrate-resistant acid phosphatase 5b(TPACP-5b)in the good recovery group were lower than those in the poor recovery group,with statistically significant differences(P<0.05);The mini nutritional assessment(MNA)score,femoral strength index(FSI),bone marrow lipid fraction(LF),and bone gla protein(BGP)levels in the good recovery group were higher than those in the poor recovery group,with statistically significant differences(P<0.05).Logistic regression analysis showed that MNA score,LF,FSI,NTX,TPACP-5b,and BGP levels were independent risk factors affecting the postoperative joint function recovery after hip fracture surgery in elderly patients,with statistically significant differences(P<0.05);Anallysis of the receiver operating characteristic(ROC)curve showed that MNA score,FSI,LF,NTX,and TPACP-5b levels have high predictive value for postoperative joint function recovery after hip fracture surgery in elderly patients,with area under curve(AUC)values of 0.936,0.874,0.866,0.884,and 0.825,respectively.The AUC value of BGP expression was 0.634,which can be used as a secondary reference.Conclusion Observing the changes in postoperative nutritional status,bone metabolism,femoral neck strength index,and bone marrow lipid fraction in elderly patients undergoing hip fracture surgery is beneficial for early prediction of postoperative hip joint function recovery,allowing for the development of corresponding prevention and control measures.It is worthy of clinical promotion and helps patients recover as soon as possible.