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肘部骨折或脱位患者血清肥大细胞类胰蛋白酶水平及其与损伤严重程度的关系。

Human serum mast cell tryptase levels in elbow fractures or dislocations and its association with injury severity.

机构信息

Department of Surgery, University of Calgary, Calgary, Alberta, Canada.

McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

J Orthop Res. 2020 Sep;38(9):2015-2019. doi: 10.1002/jor.24642. Epub 2020 Mar 11.

Abstract

Mast cells contain an abundance of tryptase, and preclinical models have shown elevated serum mast cell tryptase (SMCT) in the setting of posttraumatic joint contractures. Therefore, SMCT emerged as a potential biomarker to help recognize patients with more severe injuries and a higher likelihood of developing contractures. The objective of this study is to assess SMCT levels in participants with varying severity of elbow fractures and/or dislocations. A prospective cohort including 13 participants with more severe injuries that required an operation and 28 participants with less severe injuries managed nonoperatively were evaluated. A control group of eight individuals without elbow injuries was also evaluated. The SMCT levels were measured using an enzyme-linked immunosorbent assay kit specific for human mast cell tryptase. A one-way analysis of variance and Tukey's Honest Significance test was used to assess for statistical significance among and between the three groups. The average time from injury to the collection of the blood samples was 4 ± 2 days. Highly significant differences were identified between the operative, nonoperative, and control groups (P = .0005). In the operative group, SMCT levels were significantly higher than the nonoperative group (P = .0005) and the control group (P = .009), suggesting a correlation between SMCT levels and injury severity. There was no statistically significant difference in SMCT levels between the nonoperative and control groups. The SMCT levels were elevated in participants with acute elbow injuries requiring operative intervention, suggesting that SMCT levels were higher in injuries regarded as more severe.

摘要

肥大细胞含有丰富的类胰蛋白酶,临床前模型显示创伤后关节挛缩时血清肥大细胞类胰蛋白酶(SMCT)升高。因此,SMCT 作为一种潜在的生物标志物出现,有助于识别更严重损伤和更有可能发生挛缩的患者。本研究的目的是评估不同严重程度肘骨折和/或脱位患者的 SMCT 水平。评估了包括 13 名需要手术的严重损伤患者和 28 名非手术治疗的轻度损伤患者的前瞻性队列。还评估了 8 名无肘部损伤的对照组。使用针对人肥大细胞类胰蛋白酶的酶联免疫吸附测定试剂盒测量 SMCT 水平。使用单向方差分析和 Tukey 的诚实显着性检验评估三组之间和组内的统计学显着性。从受伤到采集血液样本的平均时间为 4 ± 2 天。手术组、非手术组和对照组之间存在显着差异(P =.0005)。在手术组中,SMCT 水平明显高于非手术组(P =.0005)和对照组(P =.009),表明 SMCT 水平与损伤严重程度之间存在相关性。非手术组和对照组之间的 SMCT 水平没有统计学差异。需要手术干预的急性肘损伤患者的 SMCT 水平升高,表明被认为更严重的损伤中 SMCT 水平更高。

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