CAJ | 학술논문

目的：通过对老年髋部骨折围术期骨代谢生化指标[Ⅰ型胶原交联 N末端肽（NTX）和骨钙素（又称骨γ-羧基谷氨酸蛋，BGP）]变化的研究，为临床老年髋部骨折围术期的抗骨质疏松治疗提供一定的帮助。方法对56例老年髋部骨折患者采用双能 X线骨密度仪行骨密度（BMD）测定，并根据BMD测定结果将56例患者分为2组：骨质疏松组（30例）和非骨质疏松组（26例）。测定56例患者，术前、术后2周血清 NTX、BGP水平。结果56例患者中术后2周30例患者（其中男9例，女21例）BMD值较成年人BMD峰值减低2．5个标准差以上，26例患者（其中男15例，女11例）BMD值较成年人BMD减低不足2．5个标准差，女性骨质疏松症发病率明显高于男性（P＜0．05）。与术前比较，56例患者术后2周血清 NTX水平均明显升高，女性、骨质疏松组术后2周血清 BGP水平则均明显降低（均P＜0．05）；与男性比较，女性术后2周血清NTX差值明显升高，血清BGP差值则明显降低（均P＜0．05）；与非骨质疏松组比较，骨质疏松组术后2周血清 NTX差值明显升高，血清 BGP 差值则明显降低（均P＜0．05）。结论老年髋部骨折患者围术期骨代谢加快，骨丢失大于骨形成，女性患者和骨质疏松患者骨丢失更明显，围术期应加强抗骨质疏松治疗。
목적：통과대노년관부골절위술기골대사생화지표[Ⅰ형효원교련 N말단태（NTX）화골개소（우칭골γ-최기곡안산단，BGP）]변화적연구，위림상노년관부골절위술기적항골질소송치료제공일정적방조。방법대56례노년관부골절환자채용쌍능 X선골밀도의행골밀도（BMD）측정，병근거BMD측정결과장56례환자분위2조：골질소송조（30례）화비골질소송조（26례）。측정56례환자，술전、술후2주혈청 NTX、BGP수평。결과56례환자중술후2주30례환자（기중남9례，녀21례）BMD치교성년인BMD봉치감저2．5개표준차이상，26례환자（기중남15례，녀11례）BMD치교성년인BMD감저불족2．5개표준차，녀성골질소송증발병솔명현고우남성（P＜0．05）。여술전비교，56례환자술후2주혈청 NTX수평균명현승고，녀성、골질소송조술후2주혈청 BGP수평칙균명현강저（균P＜0．05）；여남성비교，녀성술후2주혈청NTX차치명현승고，혈청BGP차치칙명현강저（균P＜0．05）；여비골질소송조비교，골질소송조술후2주혈청 NTX차치명현승고，혈청 BGP 차치칙명현강저（균P＜0．05）。결론노년관부골절환자위술기골대사가쾌，골주실대우골형성，녀성환자화골질소송환자골주실경명현，위술기응가강항골질소송치료。
Objective To provide help for the treatment of osteoporosis during the periopera-tive period in elderly patients with hip fracture through investigating the changes in bone metabo-lism markers cross-linked N-telopeptide of typeⅠcollagen(NTX)and osteocalcinduring(BGP). Methods The bone mineral density(BMD)was measured by dual energy X-ray absorptiometry in 5 6 elderly patients with hip fracture.According to the BMD values,these patients were divided in-to two groups:osteoporosis group(n=30)and non-osteoporosis group(n=26).Serum levels of NTX and BGP were determined before and 2 weeks after operation.Results Among the 5 6 pa-tients,30(9 males and 21 females)had BMD values more than 2.5 standard deviations below a-dult peak bone mass,and 26(15 males and 11 females)had BMD values less than 2.5 standard de-viations below adult peak bone mass.The incidence of osteoporosis in females was significantly higher than that in males 2 weeks after operation(P<0.05).Compared with preoperative levels, serum NTX increased in all patients and serum BGP decreased in females 2 weeks after operation (P<0.05).Compared with males,postoperative change in NTX levels increased and postopera-tive change in BGP levels decreased in females (P<0.05 ).Compared with non-osteoporosis group,postoperative change in NTX levels increased and postoperative change in BGP levels de-creased in osteoporosis group(P<0.05).Conclusion Elderly patients with hip fracture,especial-ly female patients and osteoporosis patients,have accelerated bone metabolism and bone loss dur-ing the perioperative period.Therefore,the anti-osteoporosis treatment should be strengthened during the perioperative period in elderly patients with hip fracture.