血清胆碱乙酰转移酶与中青年股骨颈骨折切开复位内固定术后股骨头坏死的关系

Relationship between serum choline acetyltransferase and femoral head necrosis after open reduction and internal fixation of femoral neck fractures in middle-aged and young adults

目的 观察血清胆碱乙酰转移酶(ChAT)与中青年股骨颈骨折切开复位内固定术后股骨头坏死的关系。方法 采用回顾性研究,收集2020年1月至2022年9月于中国人民解放军陆军第七十二集团军医院接受切开复位内固定治疗的83例中青年股骨颈骨折患者的临床资料,根据其术后6个月是否发生股骨头坏死分为发生组(20例)、未发生组(63例)。比较血清ChAT和基线资料,使用logistic回归分析明确血清ChAT和相关指标与术后股骨头坏死的关系,采用受试者操作特征(ROC)曲线评估血清ChAT与相关指标对患者术后股骨头坏死的预测价值。结果 发生组血清ChAT、一氧化氮(NO)水平低于未发生组(P<0.05)。多因素logistic回归分析显示,血清ChAT(OR=0.811,95%CI:0.716~0.918)与NO(OR=0.845,95%CI:0.732~0.976)是股骨颈骨折患者术后股骨头坏死的影响因素(P<0.05)。ROC曲线显示,血清ChAT对股骨颈骨折患者术后出现股骨头坏死具有良好的预测价值,曲线下面积为0.760;NO对患者术后出现股骨头坏死的预测价值较低,曲线下面积为0.679。结论 血清ChAT、NO是股骨颈骨折患者术后出现股骨头坏死的影响因素,且血清ChAT对其术后出现股骨头坏死具有良好的预测价值。

Objective To observe the relationship between serum choline acetyltransferase(ChAT) and femoral head necrosis after open reduction and internal fixation of femoral neck fractures in middle-aged and young adults.Methods A retrospective study was conducted to collect clinical data of 83 middle-aged and young patients with femoral neck fractures who underwent open reduction and internal fixation treatment at the the72nd Group Military Hospital of the Chinese People's Liberation Army from January 2020 to September 2022.They were divided into the occurrence group(20 cases) and the non occurrence group(63 cases) based on whether they experienced femoral head necrosis six months after surgery.The serum ChAT and baseline data were compared,logistic regression analysis was used to determine the relationship between serum ChAT and related indexes and postoperative femoral head necrosis and the predictive value of serum ChAT and related indicators for postoperative femoral head necrosis was evaluated by receiver operator characteristic(ROC) curve.Results The serum ChAT and nitric oxide(NO) levels of patients in the occurrence group were lower than those in the non occurrence group(P<0.05).Multivariate logistic regression analysis showed that serum ChAT(OR=0.811,95% CI:0.716-0.918) and NO(OR=0.845,95% CI:0.732-0.976) were the influencing factors for postoperative femoral head necrosis in patients with femoral neck fractures(P<0.05).The ROC curve showed that serum ChAT had good predictive value for postoperative femoral head necrosis in patients with femoral neck fractures,with an area under the curve of 0.760.The predictive value of NO for postoperative femoral head necrosis in patients was relatively low,with an area under the curve of 0.679.Conclusion ChAT and NO are the influencing factors for postoperative femoral head necrosis in patients with femoral neck fractures,and serum ChAT has good predictive value for postoperative femoral head necrosis.