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测定骨质疏松性骨折患者血清和局部血肿样本中的免疫因子水平，并对活性维生素 D3 治疗对免疫因子水平的影响进行临床研究。

Determination of immune factor levels in serum and local hematoma samples of osteoporotic fracture patients and clinical study of the effect of active vitamin D3 treatment on immune factor levels.

机构信息

Shengjing Hospital of China Medical University, Shengjing, China.

出版信息

J Orthop Surg Res. 2023 Apr 10;18(1):291. doi: 10.1186/s13018-023-03777-7.

DOI:10.1186/s13018-023-03777-7
PMID:37038178
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10088267/
Abstract

OBJECTIVE: The aim of this study was to investigate changes in systemic and local immune factors, namely, interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α, in patients with and without osteoporotic fractures and to explore the effects of active vitamin D3 treatment on immune function and fracture prognosis in patients with osteoporotic fractures. METHOD: The mRNA expression levels of IL-1β, IL-6 and TNF-α were measured before the operation. After the operation, the patients in the control group were treated with conventional fracture treatment and calcium supplementation, and the patients in the treatment group were treated with calcium plus active vitamin D3 in addition to conventional fracture treatment. The serum of each patient was collected on the seventh day after the operation. RESULTS: The expression levels of the three immune factors (IL-1β, IL-6 and TNF-α) in the fracture end hematoma samples were significantly positively correlated with those in the serum samples (P < 0.05). The mean values of the serums of IL-1β, IL-6 and TNF-α in the osteoporosis group were significantly higher than those in the non-osteoporosis group (P < 0.05). The average number of hematomas in the osteoporosis group was significantly higher than that in the non-osteoporosis group (P < 0.05). The results for the active vitamin D3 treatment group were significantly lower than those for the control group (P < 0.05). The mean wrist function score of the active vitamin D3 treatment group was significantly better than that of the control group (P < 0.05). The average fracture healing time of the treatment group was significantly shorter than that of the control group (P < 0.05). CONCLUSION: The relative expression of IL-1β, IL-6, and TNF-α in the fracture end hematoma samples was positively correlated with the corresponding levels of these immune factors in the serum samples. The levels of IL-1β, IL-6 and TNF-α in the serum and fracture end hematoma samples of the osteoporotic fracture patients were higher than those of the non-osteoporotic fracture patients. Active vitamin D3 treatment promoted fracture healing by affecting the levels of these immune factors.

摘要

目的：本研究旨在探讨伴有和不伴有骨质疏松性骨折患者的全身和局部免疫因子（白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α）的变化，并探讨活性维生素 D3 治疗对骨质疏松性骨折患者免疫功能和骨折预后的影响。

方法：在手术前测量白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α 的 mRNA 表达水平。手术后，对照组患者采用常规骨折治疗和补钙治疗，治疗组患者在常规骨折治疗的基础上加用钙加活性维生素 D3 治疗。术后第 7 天采集每位患者的血清。

结果：骨折端血肿样本中三种免疫因子（白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α）的表达水平与血清样本中相应因子的表达水平呈显著正相关（P<0.05）。骨质疏松组血清白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α 的平均值明显高于非骨质疏松组（P<0.05）。骨质疏松组的平均血肿量明显高于非骨质疏松组（P<0.05）。活性维生素 D3 治疗组的结果明显低于对照组（P<0.05）。活性维生素 D3 治疗组的腕关节功能评分平均值明显优于对照组（P<0.05）。治疗组的平均骨折愈合时间明显短于对照组（P<0.05）。

结论：骨折端血肿样本中白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α 的相对表达与血清样本中相应免疫因子的水平呈正相关。骨质疏松性骨折患者血清和骨折端血肿样本中白细胞介素 1β、白细胞介素 6 和肿瘤坏死因子-α 的水平高于非骨质疏松性骨折患者。活性维生素 D3 治疗通过影响这些免疫因子的水平促进骨折愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/aa651e281003/13018_2023_3777_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/832cecc4aa55/13018_2023_3777_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/380e5730767d/13018_2023_3777_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/0beda508c2ec/13018_2023_3777_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/aa651e281003/13018_2023_3777_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/832cecc4aa55/13018_2023_3777_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/380e5730767d/13018_2023_3777_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/0beda508c2ec/13018_2023_3777_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221c/10088267/aa651e281003/13018_2023_3777_Fig4_HTML.jpg

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