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早期和延迟性股骨骨折手术治疗患者炎症反应的评估

Evaluation of inflammatory response in patients undergoing surgical treatment for early and delayed femoral fractures.

作者信息

Moghtadaei Mehdi, Otoukesh Babak, Pazoki-Toroudi Hamidreza, Boddouhi Bahram, Yeganeh Ali

机构信息

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Science, Tehran, Iran.

Physiology Research Center, Department of Physiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Med Sci. 2019 Jan;15(1):141-145. doi: 10.5114/aoms.2016.63013. Epub 2016 Oct 17.

Abstract

INTRODUCTION

It has been shown that long bone fractures are correlated with the inflammatory response. In the initial injury, surgical reduction and fixation of fractures induce the immunoinflammatory response. This study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures.

MATERIAL AND METHODS

This study aimed to evaluate serum variation of inflammatory markers in patients undergoing surgical treatment for early and delayed femoral fractures. The patients were randomly divided into two groups using the method of block randomization including early surgery (within 24 h) and delayed surgery (after 48 h). Serum levels of inflammatory markers in both groups including interleukin (IL)-1, 5, 6, tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ) were determined using specific kits. From each patient 10 ml blood was collected for cytokine assay in their serum.

RESULTS

Our findings suggest that serum levels of IL-8 were markedly decreased from 12 h until 48 h postoperatively ( < 0.05). Moreover, the results indicated that serum levels of TNF-α were significantly increased in the early hours, but after 48 h a decreasing trend was detected ( < 0.05). Furthermore, serum levels of IL-10, IFN-γ, and IL-6 were significantly increased from 12 h until 48 h postoperatively ( < 0.05).

CONCLUSIONS

The inflammatory status of the patient may be a useful adjunct in clinical decisions. With an improved understanding of the molecular basis of the inflammatory response, and by identifying relevant clinical markers of inflammation, surgeons can better manage the timing of surgical stabilization.

摘要

引言

研究表明,长骨骨折与炎症反应相关。在初始损伤时,骨折的手术复位和固定会引发免疫炎症反应。本研究旨在评估早期和延迟性股骨骨折手术治疗患者血清炎症标志物的变化。

材料与方法

本研究旨在评估早期和延迟性股骨骨折手术治疗患者血清炎症标志物的变化。采用区组随机化方法将患者随机分为两组,包括早期手术组(24小时内)和延迟手术组(48小时后)。使用特定试剂盒测定两组患者血清中炎症标志物的水平,包括白细胞介素(IL)-1、5、6、肿瘤坏死因子α(TNF-α)和干扰素γ(IFN-γ)。从每位患者采集10ml血液用于血清细胞因子检测。

结果

我们的研究结果表明,术后12小时至48小时,IL-8血清水平显著降低(<0.05)。此外,结果表明,TNF-α血清水平在早期显著升高,但48小时后呈下降趋势(<0.05)。此外,术后12小时至48小时,IL-10、IFN-γ和IL-6血清水平显著升高(<0.05)。

结论

患者的炎症状态可能是临床决策中的一个有用辅助因素。通过更好地理解炎症反应的分子基础,并识别相关的炎症临床标志物,外科医生可以更好地把握手术稳定的时机。

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