CAJ | 학술논문

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-羟基维生素 D），同时行髋关节骨密度、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。
목적：관찰고골조륭간골절환자수술전후골대사、골밀도화골강도적변화，지도술후골질소송급골절적치료。방법40례녀성고골조륭간골절환자납입연구，측정입원후차신급술후3개월적골대사지표（Ⅰ형전효원기단전태、혈청Ⅰ형효원 C 단태、혈청골개소、갑상방선격소、25-간기유생소 D），동시행관관절골밀도、관관절골강도측정，응용 SPSS18.0분석연건，대술전급술후3개월상술지표진행통계학분석。결과술후3개월Ⅰ형전효원기단전태수평교술전명현승고，혈청Ⅰ형효원 C 단태화갑상방선격소교술전하강，삼자차이구유통계학의의（P ﹤0.05）；술후3개월，관관절골밀도、골강도경도하강，단여술전비교차이무통계학의의。결론술후3개월，고골조륭간골절환자골대사수연교술전증가，성골명현，단시골밀도、골강도무명현개변，잉응가강항골질소송치료，동시주의방호，피면발생재차골절。
Objective To observing the variation of the perioperative serum bone metabolic markers,bone mineral density and bone strength in patients with intertrochanteric fractures to guide postoperative treatment of osteoporosis and fractures. Methods Forty female patients with intertrochanteric fracture were admitted into the trial. The content of bone metabolic marker(PINP、CTX、PTH、OC、25-OH-D3)were tested after admission and three months after operation. The date of the bone mineral density and bone strength of the hip by the DXA and HSA were also collected simultaneously. All data were analyzed by SPSS 18. 0. Results Compared with the pre-operative content,the postoperative content of PINP increased while CTX and PTH decreased. The variations of the three markers were significant statistically. The change of bone mineral density and bone strength was slight decreased,but statistically significant was found. Conclusion The variation of serum bone metabolic mark-ers in patients with fragility fractures mean osteogenesis increase obviously,while the bone mineral density and bone strength didn′t improve. It still implies high fracture risk. We suggest patients with intertrochanteric fracture should improve anti-osteo-porosis treatment and pay more attention to avoid falling.