瑞舒伐他汀联合鹿瓜多肽辅助LCP内固定治疗对老年肱骨近端骨折患者骨代谢、再骨折的影响

Effects of Rosuvastatin Combined with Lugua Polypeptide Assisted Locking Compression Plate Internal Fixation on Bone Metabolism and Refracture in Elderly Patients with Proximal Humerus Fracture

目的:探讨瑞舒伐他汀联合鹿瓜多肽辅助锁定加压钢板(LCP)内固定治疗老年肱骨近端骨折患者的效果。方法:选取2022年1—8月河北省沧州中西医结合医院收治的老年肱骨近端骨折患者108例,以随机数字表法分为对照组和观察组,每组54例。在LCP内固定术后,予以对照组患者鹿瓜多肽治疗,予以观察组患者瑞舒伐他汀联合鹿瓜多肽治疗。观察两组患者的临床疗效、手术相关指标和并发症发生情况,治疗前后骨密度(BMD)、骨代谢指标[酒石酸酸性磷酸酶-5b(TRACP-5b)、Ⅰ型胶原交联氨基端肽(NTXⅠ)和骨钙素(BGP)]及骨折修复细胞因子[骨形态发生蛋白-2(BMP-2)、血管内皮生长因子(VEGF)和转化生长因子-β1(TGF-β1)]水平。结果:观察组患者的治疗优良率为92.59%(50/54),高于对照组的74.07%(40/54),差异有统计学意义(P<0.05)。观察组患者可负重时间、骨折愈合时间短于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者腰椎L3、L4BMD高于对照组;TRACP-5b、NTXⅠ水平低于对照组,BGP水平高于对照组;VEGF、BMP-2水平高于对照组,TGF-β1水平低于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为5.56%(3/54),与对照组的16.67%(9/54)相比,差异无统计学意义(P>0.05)。结论:瑞舒伐他汀联合鹿瓜多肽可加速老年肱骨近端骨折患者LCP内固定术后早期康复,促进骨折愈合,可能与瑞舒伐他汀能提高患者BMD、改善骨代谢和调节骨折修复细胞因子有关。

OBJECTIVE:To probe into the efficacy of rosuvastatin combined with Lugua polypeptide assisted locking compression plate(LCP)internal fixation in the treatment of bone metabolism and refracture in elderly patients with proximal humerus fracture.METHODS:Totally 108 elderly patients with proximal humerus fracture admitted into Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from Jan.to Aug.2022 were extracted to be divided into the control group and the observation group via the random number table method,with 54 cases in each group.After LCP internal fixation,the control group was given Lugua polypeptide,while the observation group received rosuvastatin combined with rosuvastatin.The clinical efficacy,operative related indicators,complications,bone mineral density(BMD),bone metabolism indicators such as tartrate acid phosphatase-5b(TRACP-5b),typeⅠcollagen cross-linked amino terminal peptide(NTXⅠ)and osteocalcin(BGP),fracture repair cytokines such as bone morphogenetic protein-2(BMP-2),vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)before and after treatment were observed in two groups.RESULTS:The excellent and good rate of observation group was 92.59%(50/54),higher than 74.07%(40/54)of control group,with statistically significant difference(P<0.05).Weight bearing and fracture healing time of observation group were shorter than those of control group,with statistically significant difference(P<0.05).After treatment,the L 3 and L 4 BMD of lumbar spine in observation group were higher than those in control group,the levels of TRACP-5b and NTXⅠwere lower than those in control group,the levels of BGP were higher than those in control group,the levels of VEGF and BMP-2 were higher than those in control group,the levels of TGF-β1 were lower than those in control group,with statistically significant differences(P<0.05).The complication rate of the observation group was 5.56%(3/54),compared with 16.67%(9/54)in the control group,the difference was not statistically significant(P>0.05).CONCLUSIONS:Rosuvastatin combined with Lugua polypeptide can accelerate early recovery after LCP internal fixation and promote fracture healing in elderly patients with proximal humerus fracture,which may be related to rosuvastatin can improve bone mineral density and bone metabolism,and regulate repair cytokines.