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时间:2020-06-04
《股骨粗隆间骨折患者手术前后骨代谢、骨密度和骨强度变化研究.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、实用骨科杂志第20卷,第5期,2014年5月文章编号:1008—5572(2014)05~0415—05股骨粗隆问骨折患者手术前后骨代谢、骨密度和骨强度变化研究刘伟,张旭,范永前,朱炯,沈海敏,林伟龙(复旦大学附属华东医院骨科,上海200040)摘要:目的观察股骨粗隆间骨折患者手术前后骨代谢、骨密度和骨强度的变化,指导术后骨质疏松及骨折的治疗。方法40例女性股骨粗隆间骨折患者纳入研究,测定入院后次晨及术后3个月的骨代谢指标(I型前胶原基端前肽、血清I型胶原c端肽、血清骨钙素、甲状旁腺激素、25一羟基维生素D),同时
2、行髋关节骨密度、髋关节骨强度测定,应用SPSS18.0分析软件,对术前及术后3个月上述指标进行统计学分析。结果术后3个月I型前胶原基端前肽水平较术前明显升高,血清I型胶原C端肽和甲状旁腺激素较术前下降,三者差异具有统计学意义(P<0.05);术后3个月,髋关节骨密度、骨强度轻度下降,但与术前比较差异无统计学意义。结论术后3个月,股骨粗隆间骨折患者骨代谢虽然较术前增加,成骨明显,但是骨密度、骨强度无明显改变,仍应加强抗骨质疏松治疗,同时注意防护,避免发生再次骨折。关键词:老年;股骨粗隆间骨折;围手术期;骨代谢;骨密度
3、中图分类号:R683.42文献标识码:BResearchofthePerioperativeSerumBoneMetabolicMarkers、BoneMineralDensityandBoneStrengthofPatientswithIntertrochantericFracturesLIUWei,ZHANGXu,FANYong—qian,etal(DepartmentofOrthopaedics,HuadongHospital,FudanUniversity,Shanghai200040,China)Abst
4、ract:ObjectiveToobservingthevariationoftheperioperativeserumbonemetabolicmarkers,bonemineraldensityandbonestrengthinpatientswithintertrochantericfracturestoguidepostoperativetreatmentofosteoporosisandfractures.MethodsFortyfemalepatientswithintertrochantericfra
5、cturewereadmittedintothetria1.Thecontentofbonemetabolicmarker(PINP、CTX、PTH、OC、25一OH—D3)weretestedafteradmissionandthreemonthsafteroperation.ThedateofthebonemineraldensityandbonestrengthofthehipbytheDXAandHSAwerealsocollectedsimultaneously.Alldatawerean~yzedbyS
6、PSS18.0.ResultsComparedwiththepre—operativecontent,thepostoperativecontentofPINPincreasedwhileCTXandPTHdecreased.rI'l1evariationsofthethreemarkersweresignificantstatistically.Thechangeofbonemineraldensityandbonestrengthwasslightdecreased,butstatisticallysignif
7、icantwasfound.ConclusionThevariationofserumbonemetabolicmark.ersinpatientswithfragilityfracturesmeanosteogenesisincreaseobviously,whilethebonemineraldensityandbonestrengthdidntimprove.Itstillimplieshighfracturerisk.Wesuggestpatientswithintertrochantericfractur
8、eshouldimproveanti—osteo·porosistreatmentandpaymoreattentiontoavoidfalling.Keywords:aged;intertrochantericfractures;perioperative;bonemetabolism;bonemineral随着社会的老龄化,骨质疏松的发病率日趋增高,轻微
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