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代谢紊乱和实验室检查异常在波兰老年和非老年骨科患者伤口愈合及康复中的作用——前瞻性研究

The Role of Metabolic Disorders and Laboratory Abnormalities in Wound Healing and Recovery in Geriatric and Non-Geriatric Orthopedic Patients in Poland-Prospective Research.

作者信息

Węgłowski Robert, Borowski Bartosz, Bronikowska Anna, Piech Piotr, Staśkiewicz Grzegorz, Jarecki Jaromir

机构信息

Department of Correct, Clinical and Imaging Anatomy, Medical University of Lublin, Chodźki 4 (CSM), 20-093 Lublin, Poland.

Department of Orthopedics and Traumatology, Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland.

出版信息

J Clin Med. 2025 Jul 28;14(15):5317. doi: 10.3390/jcm14155317.

Abstract

This study sought to assess the impact of diabetes and hypertension on wound healing and recovery in orthopedic patients, with an emphasis on laboratory correlations. This study included 67 orthopedic patients, divided into a geriatric group (n = 49, ≥65 years) and a control group (n = 18). Clinical and laboratory assessments were performed at admission and discharge. Data were analyzed statistically. Geriatric patients showed a higher triglyceride glucose-body mass index (TyG-BMI), glucose, cholesterol, C-reactive protein (CRP), interleukin-6 (IL-6), and leukocytes and lower hemoglobin and platelets (PLTs), with poorer healing and well-being. Elevated CRP, IL-6, and urea and decreased protein and hemoglobin persisted in this group. Diabetes improved outcomes in older adults, while hypertension worsened them in younger patients. Favorable outcomes correlated with higher triglycerides, fibrinogen, hemoglobin, and red blood cells (RBCs), while they did not correlate with elevated CRP, IL-6, leptin, urea, creatinine, and white blood cells (WBCs). Key predictors of healing and well-being included CRP, hemoglobin, RBC, and hematocrit in older patients and hypertension, CRP, hemoglobin, and leptin in younger individuals. Age-specific metabolic and inflammatory profiles influence recovery trajectories and may be used to predict problems in both recovery and patients' well-being. Further research is required to better understand the correlations between these factors.

摘要

本研究旨在评估糖尿病和高血压对骨科患者伤口愈合及恢复的影响,并着重研究实验室指标之间的相关性。本研究纳入了67例骨科患者,分为老年组(n = 49,年龄≥65岁)和对照组(n = 18)。在入院时和出院时进行临床和实验室评估。对数据进行统计学分析。老年患者的甘油三酯葡萄糖-体重指数(TyG-BMI)、血糖、胆固醇、C反应蛋白(CRP)、白细胞介素-6(IL-6)和白细胞水平较高,而血红蛋白和血小板(PLT)水平较低,伤口愈合情况及身体状况较差。该组患者的CRP、IL-6和尿素水平持续升高,蛋白质和血红蛋白水平持续降低。糖尿病改善了老年人的预后,而高血压则使年轻患者的预后恶化。良好的预后与较高的甘油三酯、纤维蛋白原、血红蛋白和红细胞(RBC)水平相关,而与CRP、IL-6、瘦素、尿素、肌酐和白细胞(WBC)水平升高无关。老年患者伤口愈合及身体状况的关键预测指标包括CRP、血红蛋白、RBC和血细胞比容,而年轻患者的关键预测指标包括高血压、CRP、血红蛋白和瘦素。特定年龄的代谢和炎症特征会影响恢复轨迹,可用于预测恢复过程及患者身体状况方面的问题。需要进一步研究以更好地理解这些因素之间的相关性。

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