【摘要】 目的 探讨经皮椎体后凸成形术(PKP)治疗椎体压缩性骨折瘦素、脂联素及Ⅰ型胶原蛋白C末端异物肽(CTX-Ⅰ)水平。方法 选取2019年6月至2022年5月南京中医药大学附属南京市中西医结合医院收治的92例椎体压缩性骨折患者为研究对象,根据治疗方式的不同分为对照组45例[予经皮椎弓根螺钉内固定术(PPSF)]、观察组47例(予PKP治疗);比较两组瘦素、脂联素和CTX-Ⅰ水平、分析观察组不同临床特征与病理特征的瘦素、脂联素和CTX-Ⅰ水平、采用多元Logistic回归分析影响观察组瘦素、脂联素和CTX-Ⅰ水平的危险因素,比较两组临床疗效及并发症情况。结果 观察组血清瘦素水平高于对照组,脂联素和CTX-Ⅰ水平均低于对照组,差异具有统计学意义(P<0.05);观察组不同年龄段、有无骨折病史、术前骨折椎体数和术中骨水泥量之间瘦素水平比较差异有统计学意义(P<0.05);不同性别、不同年龄段、有无骨折病史和术中骨水泥量之间脂联素水平比较差异有统计学意义(P<0.05);不同性别、不同年龄段、有无骨折病史和术中骨水泥量之间CTX-Ⅰ水平比较差异有统计学意义(P<0.05);经多元Logistic回归分析可知,女性、年龄>62岁、有骨折病史、术前骨折椎体数≥2个及术中骨水泥量使用1～5 mL为影响瘦素、脂联素和CTX-Ⅰ水平的危险因素(P<0.05);观察组临床总有效率(95.74%)高于对照组(82.22%),差异具有统计学意义(P<0.05);观察组并发症总发生率(2.13%)比对照组(13.33%)低,差异具有统计学意义(P<0.05)。结论 经PKP治疗能有效提高椎体压缩性骨折患者的临床疗效,有效改善患者血清瘦素、脂联素及CTX-Ⅰ水平,通过检测上述三指标水平可对PKP术后治疗提供参考依据。更多还原

【Abstract】 Objective To investigate the leptin,adiponectin and type Ⅰ collagen C-terminal foreign body peptide(CTX-Ⅰ)levels in the treatment of vertebral compression fractures by percutaneous kyphoplasty(PKP). Methods 92 patients with vertebral compression fractures admitted to Nanjing Hospital of Integrated Traditional and Western Medicine Affiliated to Nanjing University of Chinese Medicine from June 2019 to May 2022 were selected as the study objects,and according to different treatment methods,they were divided into 45 cases in the control group[given percutaneous pedicle screw internal fixation(PPSF)],47 cases in the observation group(given PKP treatment);the leptin,adiponectin and CTX-Ⅰ levels in the two groups were compared,and the leptin,adiponectin and CTX-Ⅰ levels in the observation group with different clinical and pathological features were analyzed,and Multivariate Logistic regression analysis was used to analyze the risk factors affecting the leptin,adiponectin and CTX-Ⅰ levels in the observation group,and the clinical efficacy and complications were compared between the two groups. Results The serum leptin level in the observation group was higher than that in the control group,and the serum adiponectin and CTX-Ⅰ levels in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).There were significant differences in leptin levels between different age groups,fracture history,preoperative fracture vertebral body number and intraoperative bone cement volume in the observation group(P<0.05).There were statistically significant differences in adiponectin levels among different genders,different age groups,fracture history and intraoperative bone cement volume(P<0.05). There were statistically significant differences in CTX-Ⅰ levels between different genders,different age groups,whether there was a history of fracture,and the amount of bone cement during operation(P<0.05). Multiple logistic regression analysis showed that women,age >62 years old,and a history of fracture,the number of preoperative fractured vertebrae ≥ 2,and intraoperative bone cement volume of 1～5 mL were the risk factors affecting the leptin,adiponectin and CTX-Ⅰ levels(P<0.05). The total clinical effective rate in the observation group(95.74%)was higher than that in the control group(82.22%),and the difference was statistically significant(P<0.05). The total incidence of complications in the observation group(2.13%)was lower than that in the control group(13.33%),and the difference was statistically significant(P<0.05). Conclusion PKP treatment can effectively improve the clinical efficacy of patients with vertebral compression fracture,and effectively improve the levels of serum leptin,adiponectin and CTX-Ⅰ in patients with vertebral compression fracture. Detecting the levels of these three indicators can provide a reference basis for postoperative treatment of PKP.更多还原