84年鼠女哪年财运最旺,857comvvv色九欧美激情|85PO_87国产精品欲av国产av资源

[1]金華,顏夏衛(wèi).血清25-羥基維生素D與胰島素樣生長(zhǎng)因子-1水平對(duì)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后的影響[J].中醫(yī)正骨,2023,35(08):14-19,36.
　JIN Hua,YAN Xiawei.Effects of serum levels of 25-hydroxy vitamin D and insulin-like growth factor-1 on prognosis after internal fixation for distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(08):14-19,36.
點(diǎn)擊復(fù)制

血清25-羥基維生素D與胰島素樣生長(zhǎng)因子-1水平對(duì)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后的影響()
分享到：

《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年08期
頁(yè)碼:
14-19,36
欄目:
臨床研究
出版日期:
2023-08-20

文章信息/Info

Title:
Effects of serum levels of 25-hydroxy vitamin D and insulin-like growth factor-1 on prognosis after internal fixation for distal radius fractures
作者:
金華; 顏夏衛(wèi)
臺(tái)州骨傷醫(yī)院,浙江 溫嶺 317500
Author(s):
JIN Hua; YAN Xiawei
Taizhou Orthopedics Hospital,Wenling 317500,Zhejiang,China
關(guān)鍵詞:
橈骨骨折;  腕損傷;  骨折固定術(shù); 內(nèi);  預(yù)后;  羥基膽骨化醇類;  胰島素樣生長(zhǎng)因子-Ⅰ
Keywords:
radius fractures;  wrist injuries;  fracture fixation; internal;  prognosis;  hydroxycholecalciferols;  insulin-like growth factor I
摘要:
目的:探討血清25-羥基維生素D[25-hydroxy vitamin D,25(OH)D]、胰島素樣生長(zhǎng)因子-1(insulin-like growth factor-1,IGF-1)水平對(duì)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后的影響。方法:以2020年1月至2022年6月在臺(tái)州骨傷醫(yī)院接受同一組醫(yī)生完成的切開(kāi)復(fù)位鋼板螺釘內(nèi)固定手術(shù)治療的橈骨遠(yuǎn)端骨折患者為研究對(duì)象。收集患者的年齡、性別、致傷原因、骨折AO分型、受傷至手術(shù)時(shí)間、手術(shù)入路、術(shù)中復(fù)位情況、術(shù)后開(kāi)始鍛煉時(shí)間、優(yōu)勢(shì)手及合并同側(cè)其他骨折等一般資料。隨訪觀察患側(cè)腕關(guān)節(jié)情況,依據(jù)Gartland和Werley腕關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)對(duì)患側(cè)腕關(guān)節(jié)進(jìn)行評(píng)分,≤8分為預(yù)后良好,≥9分為預(yù)后不良。分別于術(shù)前、術(shù)后1周、術(shù)后4周、術(shù)后6周時(shí),采用電化學(xué)發(fā)光法檢測(cè)血清25(OH)D水平,采用ELISA法檢測(cè)血清IGF-1水平。根據(jù)術(shù)后6個(gè)月時(shí)患側(cè)腕關(guān)節(jié)情況將納入病例分為預(yù)后良好組和預(yù)后不良組。比較2組患者一般資料和手術(shù)前后血清25(OH)D、IGF-1水平,分析影響預(yù)后的因素,評(píng)價(jià)血清25(OH)D、IGF-1水平對(duì)預(yù)后不良的預(yù)測(cè)價(jià)值。結(jié)果:①一般結(jié)果。共納入98例患者,預(yù)后良好組68例,預(yù)后不良組30例。2組患者骨折AO分型的組間差異有統(tǒng)計(jì)學(xué)意義(χ2=11.575,P=0.003)。②血清25(OH)D、IGF-1水平檢測(cè)結(jié)果。術(shù)后第4周和術(shù)后第6周時(shí),預(yù)后不良組血清25(OH)D、IGF-1水平均低于預(yù)后良好組[(25.47±6.06)nmol·L-1,(16.54±3.92)nmol·L-1,t=7.405,P=0.000;(36.42±7.10)nmol·L-1,(16.94±3.84)nmol·L-1,t=14.117,P=0.000;(292.36±58.64)ng·mL-1,(216.45±43.76)ng·mL-1,t=6.346,P=0.000;(402.75±66.48)ng·mL-1,(228.34±46.59)ng·mL-1,t=13.011,P=0.000]。③橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后不良的影響因素分析結(jié)果。術(shù)后第4周時(shí)血清25(OH)D、IGF-1水平是橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后不良的影響因素(β=-0.172,P=0.001,OR=0.842; β=-0.217,P=0.003,OR=0.805)。④血清25(OH)D、IGF-1水平對(duì)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后不良的預(yù)測(cè)價(jià)值評(píng)價(jià)結(jié)果。術(shù)后第4周時(shí)血清25(OH)D、IGF-1水平分別預(yù)測(cè)及二者聯(lián)合預(yù)測(cè)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后不良的受試者操作特征曲線下面積分別為0.812(P=0.000)、0.785(P=0.000)、0.906(P=0.000),靈敏度分別為67.6%、57.4%、83.8%,特異度分別為80.0%、93.3%、86.7%,2項(xiàng)指標(biāo)的臨界值分別為21.99 nmol·L-1、267.32 ng·mL-1。結(jié)論:術(shù)后第4周時(shí)血清25(OH)D、IGF-1水平對(duì)橈骨遠(yuǎn)端骨折內(nèi)固定術(shù)后預(yù)后不良有一定預(yù)測(cè)價(jià)值。
Abstract:
Objective:To explore the effects of serum levels of 25-hydroxy vitamin D(25(OH)D)and insulin-like growth factor-1(IGF-1)on prognosis of patients who underwent internal fixation for treatment of distal radius fractures.Methods:The patients who underwent open reduction and plate-screws internal fixation for treatment of distal radius fractures by the same surgeons in Taizhou Orthopedics Hospital from January 2020 to June 2022 were selected as the subjects,and their information including age,gender,cause of injury,AO fracture classification,time from injury to surgery,surgical approach,intraoperative reduction,postsurgical exercises start time,dominant hands and combined other ipsilateral fractures was collected.The patients were followed up and the affected wrist was observed.The affected wrist was scored according to the Gartland-Werley wrist scoring criteria,and the prognosis was evaluated according to the scores.The score of≤8 points was classified as favorable prognosis,while the score of≥9 points as unfavorable prognosis.The serum levels of 25(OH)D and IGF-1 were detected by using electrochemiluminescence(ECL)method and ELISA method before the surgery and at postsurgical week 1,4 and 6 respectively.According to the prognosis of affected wrist at postsurgical month 6,the included patients were divided into favorable prognosis group and unfavorable prognosis group.The general data of patients and the presurgical and postsurgical serum levels of 25(OH)D and IGF-1 were compared between the 2 groups.Moreover,the factors influencing prognosis were analyzed,and the value of the serum levels of 25(OH)D and IGF-1 in predicting unfavorable prognosis was evaluated.Results:①Ninety-eight patients were enrolled in the study,68 cases in favorable prognosis group and 30 cases in unfavorable prognosis group.There was statistical difference in AO fracture classification between the 2 groups(χ2=11.575,P=0.003).②The serum levels of 25(OH)D and IGF-1 were lower in unfavorable prognosis group compared to favorable prognosis group at postsurgical week 4 and 6(25.47±6.06 vs 16.54±3.92 nmol/L,t=7.405,P=0.000; 36.42±7.10 vs 16.94±3.84 nmol/L,t=14.117,P=0.000; 292.36±58.64 vs 216.45±43.76 ng/mL,t=6.346,P=0.000; 402.75±66.48 vs 228.34±46.59 ng/mL,t=13.011,P=0.000).③The serum levels of 25(OH)D and IGF-1 at postsurgical week 4 were the factors influencing unfavorable prognosis after internal fixation for distal radius fractures(β=-0.172,P=0.001,OR=0.842; β=-0.217,P=0.003,OR=0.805).④The applied value of serum levels of 25(OH)D and IGF-1 at postsurgical week 4 in individual prediction or unified prediction of unfavorable prognosis after internal fixation for distal radius fractures was evaluated and analyzed by using receiver operating characteristic(ROC)curve; and the results showed that the areas under the ROC curves were 0.812(P=0.000),0.785(P=0.000)and 0.906(P=0.000); the sensitivities were 67.6%,57.4% and 83.8%; and the specificities were 80.0%,93.3% and 86.7% respectively; moreover,the critical values of the two indexes were 21.99 nmol/L and 267.32 ng/mL respectively.Conclusion:The serum levels of 25(OH)D and IGF-1 at postsurgical week 4 have a certain application value in prediction of unfavorable prognosis after internal fixation for distal radius fractures.

參考文獻(xiàn)/References:

[1] 韓威,陳鄭,陳建,等.掌側(cè)微創(chuàng)手術(shù)治療橈骨遠(yuǎn)端骨折療效分析[J].中國(guó)現(xiàn)代手術(shù)學(xué)雜志,2020,24(2):107-112.
[2] MUURLING M,LÖTTERS F J B,GEELEN J E,et al.A long-term effect of distal radius fracture on the sensorimotor control of the wrist joint in older adults[J].J Hand Ther,2021,34(4):567-576.
[3] 黎金煥,陳躍平,董盼鋒,等.CT三維重建技術(shù)在橈骨遠(yuǎn)端骨折術(shù)后評(píng)價(jià)中的應(yīng)用[J].中醫(yī)正骨,2017,29(6):28-31.
[4] BELLOTI J C,ALVES B V P,FALOPPA F,et al.The ma-lunion of distal radius fracture:corrective osteotomy through planning with prototyping in 3D printing[J].Injury,2021,52 Suppl 3:S44-S48.
[5] SHIHAB Z,SIVAKUMAR B,GRAHAM D,et al.Outcomes of arthroscopic-assisted distal radius fracture volar plating:a meta-analysis[J].J Hand Surg Am,2022,47(4):330-340.
[6] 金少楓,蘇坤陽(yáng),陳畢能,等.超聲引導(dǎo)下經(jīng)皮松解術(shù)治療老年橈骨遠(yuǎn)端骨折非手術(shù)治療后腕部指屈肌腱粘連[J].中醫(yī)正骨,2022,34(8):12-19.
[7] 趙玉果,程省,湯立新,等.鎖定加壓鋼板結(jié)合Herbert螺釘內(nèi)固定治療橈骨遠(yuǎn)端骨折合并同側(cè)舟骨骨折[J].中醫(yī)正骨,2020,32(4):48-51.
[8] 程亞博.腕關(guān)節(jié)鏡技術(shù)聯(lián)合切開(kāi)復(fù)位內(nèi)固定術(shù)治療FernandezⅣ型橈骨遠(yuǎn)端骨折[J].中醫(yī)正骨,2020,32(4):52-54.
[9] MICHAËLSSON K,BYBERG L,SVENNBLAD B,et al.Serum 25-hydroxyvitamin D is associated with fracture risk only during periods of seasonally high levels in women with a high body mass index[J].J Bone Miner Res,2021,36(10):1957-1966.
[10] ABE S,KASHII M,SHIMADA T,et al.Relationship between distal radius fracture severity and 25-hydroxyvitamin-D level among perimenopausal and postmenopausal women[J].Bone Jt Open,2022,3(3):261-267.
[11] BILINSKI W J,SZTERNEL L,SIODMIAK J,et al.Low serum 25-hydroxyvitamin d level does not adversely affect bone turnover in prepubertal children[J].Nutrients,2021,13(10):3324.
[12] GUO J Y,ZHANG YQ,LI Y,et al.Comparison of the difference in serum insulin growth factor-1 levels between chronological age and bone age among children[J].Clin Biochem,2021,96:63-70.
[13] KOIZUMI M,KONISHI A,ETANI Y,et al.Circulating insulin-like growth factor 1 levels are reduced in very young children with Prader-Willi syndrome independent of anthropometric parameters and nutritional status[J].Clin Endocrinol(Oxf),2022,96(3):346-352.
[14] 劉云鵬,劉沂.骨與關(guān)節(jié)損傷和疾病的診斷分類及功能評(píng)定標(biāo)準(zhǔn)[M].北京:清華大學(xué)出版社,2002:37-38.
[15] 蔣協(xié)遠(yuǎn),王大偉.骨科臨床療效評(píng)價(jià)標(biāo)準(zhǔn)[M].北京:人民衛(wèi)生出版社,2005:37-38.
[16] BOUILLON R,MANOUSAKI D,ROSEN C,et al.The health effects of vitamin D supplementation:evidence from human studies[J].Nat Rev Endocrinol,2022,18(2):96-110.
[17] BERTOLDO F,CIANFEROTTI L,DI MONACO M,et al.Definition,assessment,and management of vitamin D inadequacy:suggestions,recommendations,and warnings from the italian society for osteoporosis,mineral metabolism and bone diseases(SIOMMMS)[J].Nutrients,2022,14(19):4148.
[18] 許昊,李毅中,莊華烽,等.血清25羥維生素D水平與脆性髖部骨折關(guān)系的研究[J].中國(guó)骨質(zhì)疏松雜志,2020,26(3):340-344.
[19] YUAN S,WAN Z H,CHENG S L,et al.Insulin-like growth factor-1,bone mineral density,and fracture:a mendelian randomization study[J].J Clin Endocrinol Metab,2021,106(4):e1552-e1558.
[20] MAZZIOTTI G,LANIA A G,CANALIS E.Skeletal disorders associated with the growth hormone-insulin-like growth factor 1 axis[J].Nat Rev Endocrinol,2022,18(6):353-365.
[21] DELAGRANGE M,ROUSSEAU V,CESSANS C,et al.Low bone mass in Noonan syndrome children correlates with decreased muscle mass and low IGF-1 levels[J].Bone,2021,153:116170.
[22] SAEKI C,OIKAWA T,UEDA K,et al.Serum insulin-like growth factor 1 levels,facture risk assessment tool scores and bone disorders in patients with primary biliary cholangitis[J].Diagnostics(Basel),2022,12(8):1957.
[23] 唐菁華,孫秀勤,王建軍.DR、MSCT檢查對(duì)不同分型兒童橈骨遠(yuǎn)端骨折的鑒別診斷價(jià)值對(duì)比[J].中國(guó)CT和MRI雜志,2020,18(11):148-149.

相似文獻(xiàn)/References:

[1]張容超,徐衛(wèi)國(guó),萬(wàn)春友,等.手法整復(fù)小夾板固定治療橈骨遠(yuǎn)端骨折168例[J].中醫(yī)正骨,2015,27(11):61.
[2]徐善強(qiáng),陳星,張興平,等.功能鍛煉對(duì)橈骨遠(yuǎn)端骨折拆除石膏外固定后 腕關(guān)節(jié)康復(fù)的影響[J].中醫(yī)正骨,2015,27(10):58.
[3]趙萌,陳云豐,周祖忠.切開(kāi)復(fù)位T形鋼板聯(lián)合空心釘內(nèi)固定治療 MasonⅢ型橈骨頭骨折[J].中醫(yī)正骨,2015,27(07):58.
[4]劉昕,鄧志強(qiáng),葉家軍.撬撥復(fù)位彈性髓內(nèi)釘固定治療JudetⅣ型兒童橈骨頸骨折[J].中醫(yī)正骨,2015,27(12):65.
[5]劉欣,劉文剛,吳淮,等.3種方法治療C型橈骨遠(yuǎn)端骨折的對(duì)比研究[J].中醫(yī)正骨,2015,27(05):12.
　LIU Xin,LIU Wengang,WU Huai,et al.A comparative study of three methods for treatment of type C distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):12.
[6]郭世明,石玲玲,郭志民,等.手法復(fù)位石膏外固定和切開(kāi)復(fù)位鋼板內(nèi)固定治療 骨質(zhì)疏松性橈骨遠(yuǎn)端骨折的比較研究[J].中醫(yī)正骨,2015,27(04):15.
　GUO Shiming,SHI Lingling,GUO Zhimin,et al.A comparative study of manual reduction and plaster external fixation versus open reduction and plate internal fixation for treatment of osteoporotic distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):15.
[7]明曉鋒,陳登山,張曉強(qiáng).閉合復(fù)位彈性髓內(nèi)釘固定和經(jīng)皮克氏針撬撥復(fù)位固定 治療兒童O'BrienⅡ、Ⅲ型橈骨頸骨折的療效比較[J].中醫(yī)正骨,2016,28(02):15.
　MING Xiaofeng,CHEN Dengshan,ZHANG Xiaoqiang.A clinical comparison of closed reduction and internal fixation with elastic intramedullary nails versus percutaneous leverage reduction and internal fixation with Kirschner wire for treatment of O'Brien typeⅡandⅢradial neck fractures in children[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2016,28(08):15.
[8]王仲鋒,王曉,李國(guó)軍,等.骨折三維形態(tài)分型在MasonⅡ型橈骨頭骨折 Herbert螺釘內(nèi)固定術(shù)中的應(yīng)用[J].中醫(yī)正骨,2016,28(03):38.
[9]鄭移兵,鮑樹(shù)仁,齊越峰,等.推壓手法復(fù)位紙夾板外固定治療Smith骨折[J].中醫(yī)正骨,2016,28(03):45.
[10]王國(guó)林,高彥平,樊培新.手法復(fù)位經(jīng)皮克氏針內(nèi)固定硫酸鈣填充治療橈骨遠(yuǎn)端粉碎性骨折[J].中醫(yī)正骨,2016,28(03):48.
[11]黎金煥,陳躍平,董盼鋒,等.CT三維重建技術(shù)在橈骨遠(yuǎn)端骨折術(shù)后評(píng)價(jià)中的應(yīng)用[J].中醫(yī)正骨,2017,29(06):28.
　LI Jinhuan,CHEN Yueping,DONG Panfeng,et al.Application of 3D reconstructed CT imaging technique to postoperative evaluation of distal radius fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(08):28.
[12]彭松云,熊屹,唐良華,等.自制量表在非手術(shù)治療老年橈骨遠(yuǎn)端骨折療效評(píng)價(jià)中的應(yīng)用價(jià)值[J].中醫(yī)正骨,2020,32(03):42.
[13]孫軼韜,馬奇翰,戴宇祥,等.橈骨遠(yuǎn)端骨折的中醫(yī)非手術(shù)治療及相關(guān)并發(fā)癥的研究進(jìn)展[J].中醫(yī)正骨,2021,33(01):43.
[14]孫濱,李琳琳,孫衛(wèi)強(qiáng),等.閉合復(fù)位經(jīng)皮穿針內(nèi)固定治療尺橈骨遠(yuǎn)端不穩(wěn)定性骨折[J].中醫(yī)正骨,2024,36(12):70.

更新日期/Last Update: 1900-01-01