股骨粗隆间骨折老年患者术后髋关节功能与血清炎性因子水平相关性分析

Correlation between postoperative hip function and serum inflammatory factors in elderly patients with intertrochanteric fracture of femur

目的探讨股骨粗隆间骨折(IFF)老年患者术后髋关节功能与血清炎性因子水平的相关性。方法选取2020-06-08-2022-06-30南阳市第二人民医院收治的IFF患者84例作为研究对象,术后进行6个月的跟踪随访,并于术后6个月采用Harris髋关节功能评分对患者髋关节功能进行评估,将Harris评分≥80分的64例患者纳入良好组,将Harris评分<80分的20例患者纳入一般组。查阅患者资料,收集患者基线资料,并于入院时检测患者血清炎性因子〔白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)〕水平,重点分析IFF老年患者术后髋关节功能与血清炎性因子水平的关系。结果良好组血清IL-6(30.88±5.82)pg·mL^(-1)、TNF-α(43.18±6.41)pg·mL^(-1)水平低于一般组的(42.14±6.32)pg·mL^(-1)、(55.49±7.51)pg·mL^(-1),差异有统计学意义,t值分别为7.400、7.193、均P<0.05;全麻占比(39.06%)低于一般组(70.00%),差异有统计学意义,χ^(2)=5.864,P<0.05;logistic回归分析结果显示,血清IL-6、TNF-α水平高表达、麻醉方式为全麻可能是IFF老年患者术后髋关节功能一般的风险因子,OR值分别为1.147、1.162、3.640,均P<0.05;绘制受试者工作(ROC)曲线发现,血清IL-6、TNF-α单一及联合预测IFF老年患者术后髋关节功能一般风险的曲线下面积(AUC)分别为0.737、0.762、0.843,有一定预测价值。结论IFF老年患者血清炎性因子水平与术后髋关节功能密切相关,或可用于预测患者术后康复情况。

Objective To investigate the correlation between postoperative hip function and serum inflammatory factors in elderly patients with intertrochanteric fracture(IFF).Methods Eighty-four IFF patients admitted to Nanyang Second People's Hospital from June 8,2020 to June 30,2022 were selected as the study objects.A 6-month postoperative follow-up was conducted,and the hip function of patients was evaluated by Harris hip function score 6 months after surgery.Sixty-four patients with Harris score≥80 were included in the good group,and 20 patients with Harris score<80 were included in the general group.Patients'data were consulted,baseline data were collected,and serum inflammatory factors[INTER leukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels were detected on admission.The focus was on the analysis of the relationship between postoperative hip function and serum inflammatory factors in elderly PATIENTS with IFF.Results Serum levels of IL-6(30.88±5.82)pg·mL^(-1)and TNF-α(43.18±6.41)pg·mL^(-1)in good group were lower than those in general group(42.14±6.32)pg·mL^(-1)and(55.49±7.51)pg·mL^(-1),and the difference was statistically significant,t=7.400,7.193,P<0.05.The proportion of general anesthesia(39.06%)was lower than that of the general group(70.00%),and the difference was statistically significant,χ^(2)=5.864,P<0.05.Logistic regression analysis showed that high expression of serum IL-6 and TNF-αand general anesthesia may be risk factors for general hip function in elderly PATIENTS with IFF(OR=1.147,1.162,3.640,all P<0.05).ROC curve showed that the AUC of serum IL-6 and TNF-αfor predicting the general risk of postoperative hip function in IFF elderly patients were 0.737,0.762 and 0.843,respectively,which had certain predictive value.Conclusion Serum inflammatory factors in elderly patients with IFF are closely related to postoperative hip function,which may be used to predict postoperative recovery of patients.