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髋关节骨折患者的炎症细胞因子白细胞介素 6 和肿瘤坏死因子-α。

Inflammatory cytokines IL-6 and TNF-α in patients with hip fracture.

机构信息

Department of Biophysics, Istanbul University Cerrahpaşa Medical Faculty, Istanbul, Turkey.

Department of Nutrition and Dietetics, Beykent University, Istanbul, Turkey.

出版信息

Osteoporos Int. 2019 May;30(5):1025-1031. doi: 10.1007/s00198-019-04874-2. Epub 2019 Jan 30.

Abstract

UNLABELLED

Mortality and remaining bedridden following the hip fracture surgery are not rare. We tried to measure the levels of inflammatory markers tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) following the hip fracture surgery and compare their levels with controls. We aimed to show a relationship between the levels of these markers and post-operative mortality and walking capability.

INTRODUCTION

Osteoporosis is a condition, causing the hip fractures in the elderly. Hip fractures have a high rate of overall mortality up to 30% following the incident. Cytokines such as IL-6 and TNF-α are suggested to play a role in bone resorption and, thus, in the etiology of osteoporosis.

METHODS

Plasma levels of IL-6 and TNF-α were measured pre-operatively and on the first and second days after the surgery in 40 Turkish hip fracture patients. The levels of these cytokines were compared with 40 Turkish age-matched healthy controls. The levels of these cytokines were compared between the deceased and surviving patients, as well as the existence of walking capability following the surgery.

RESULTS

Significantly higher IL-6 levels were shown on the first and second days after the surgery (p = 0.005; p = 0.01, respectively). The overall death rate of our study group within the 2-year follow-up time was found to be 35%. No statistical significance was found in the means of 2-year follow-up mortality between the patients. Presence of walking capability did not differ between the patients, as well.

CONCLUSION

We demonstrated an association between IL-6 levels and hip fracture in our study group following the surgery. We also suggest that TNF-α and IL-6 levels are not related to the occurrence of death and walking capability after the surgery. However, these findings need further functional and clinical confirmation.

摘要

目的

本研究旨在测量髋部骨折手术后炎症标志物肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)的水平,并与对照组进行比较,以显示这些标志物的水平与术后死亡率和行走能力之间的关系。

背景

骨质疏松症是一种导致老年人髋部骨折的疾病。髋部骨折的总死亡率很高,发病后高达 30%。细胞因子如 IL-6 和 TNF-α被认为在骨吸收中起作用,因此在骨质疏松症的发病机制中起作用。

方法

测量了 40 名土耳其髋部骨折患者手术前、手术后第 1 天和第 2 天的血浆 IL-6 和 TNF-α水平,并与 40 名土耳其年龄匹配的健康对照者进行了比较。比较了这些细胞因子在死亡和存活患者之间的水平,以及手术后是否具有行走能力。

结果

手术后第 1 天和第 2 天的 IL-6 水平显著升高(p=0.005;p=0.01)。在 2 年随访期间,我们研究组的总死亡率为 35%。在患者中,2 年随访死亡率的平均值之间没有统计学意义。患者的行走能力也没有差异。

结论

我们在手术后的研究组中发现了 IL-6 水平与髋部骨折之间的关联。我们还表明,TNF-α和 IL-6 水平与手术后的死亡和行走能力无关。然而,这些发现需要进一步的功能和临床验证。

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