Ouyang Xiao, Ding Yunzhi, Yu Li, Xin Feng, Yang Xiaowei, Sha Peng, Tong Songming, Cheng Qi, Xu Yi Qi
Department of Orthopedic Surgery, Affiliated Xuzhou Hospital of Jiangsu University, Xuzhou Third Hospital, Xuzhou, Jiangsu 221005, P.R. China.
Exp Ther Med. 2019 Dec;18(6):4583-4590. doi: 10.3892/etm.2019.8158. Epub 2019 Nov 1.
This study aimed to explore the improvement of hip replacement combined with alendronate sodium on the condition of patients with osteoporotic femoral neck fracture and factors affecting the efficacy of patients. In total, 140 patients with femoral neck fracture from July 2015 to October 2017 in the Affiliated Xuzhou Hospital of Jiangsu University were collected. Of these, 61 patients were treated with hip replacement as the control group and 79 patients were treated with alendronate sodium as the observation group on the basis of the control group. ELISA was used to detect levels of carboxy-terminal opeptide of type I collagen (CTX-I) and bone alkaline phosphatase (BALP) in serum of patients before and after treatment. Harris score was used to compare the clinical efficacy of patients after treatment. Changes in the expression of CTX-I and BALP before and after treatment were compared between the two groups, and the correlation between CTX-I and BALP levels and Harris score was analyzed. According to the clinical efficacy of patients, the two groups were divided into the significant effect group and poor effect group. Risk factors affecting the efficacy of patients were analyzed, and the ROC of subjects with risk factors was drawn. After treatment, the expression of BALP in serum increased significantly compared with that before treatment, and the expression of CTX-I decreased significantly. After treatment, the expression of BALP in serum in the observation group was significantly higher than that in the control group (P<0.05). Multivariate analysis revealed that age, time of operation, CTX-I after treatment and BALP after treatment were independent risk factors affecting the efficacy of patients. In conclusion, hip replacement combined with alendronate sodium can effectively improve the clinical efficacy of patients, and age, time of operation, CTX-I after treatment and BALP after treatment are found to be independent risk factors affecting the postoperative efficacy of patients.
本研究旨在探讨髋关节置换联合阿仑膦酸钠对骨质疏松性股骨颈骨折患者病情的改善情况以及影响患者疗效的因素。共收集了2015年7月至2017年10月在江苏大学附属徐州医院的140例股骨颈骨折患者。其中，61例患者接受髋关节置换作为对照组，79例患者在对照组基础上接受阿仑膦酸钠治疗作为观察组。采用酶联免疫吸附测定法（ELISA）检测患者治疗前后血清中Ⅰ型胶原羧基末端肽（CTX-I）和骨碱性磷酸酶（BALP）水平。采用Harris评分比较患者治疗后的临床疗效。比较两组治疗前后CTX-I和BALP表达的变化，并分析CTX-I和BALP水平与Harris评分的相关性。根据患者的临床疗效，将两组分为显效组和无效组。分析影响患者疗效的危险因素，并绘制有危险因素受试者的ROC曲线。治疗后，血清中BALP的表达较治疗前显著升高，CTX-I的表达显著降低。治疗后，观察组血清中BALP的表达显著高于对照组（P<0.05）。多因素分析显示，年龄、手术时间、治疗后CTX-I和治疗后BALP是影响患者疗效的独立危险因素。综上所述，髋关节置换联合阿仑膦酸钠可有效提高患者的临床疗效，且发现年龄、手术时间、治疗后CTX-I和治疗后BALP是影响患者术后疗效的独立危险因素。
