【摘要】 目的 研究生物可利用25(OH)D、甲状旁腺素对老年脆性髋部骨折术后功能恢复的影响。方法 采用前瞻性队列研究，收集我院2017年5月至2021年11月318例老年髋部骨折患者，选取同时期在体检中心参加体检的健康人为对照组，采用自行设计调查问卷进行调查，检测钙、白蛋白、维生素D结合蛋白、总25(OH)D、甲状旁腺素水平，计算生物可利用25(OH)D水平。随访评价髋部骨折患者术后功能表现，采用多因素Logistic回归模型分析生物可利用25(OH)D、甲状旁腺素与老年脆性髋部骨折功能的相关性。采用受试者工作曲线下面积(receiver operating characteristic, ROC)研究生物可利用25(OH)D、甲状旁腺素与老年脆性髋部骨折术后功能的预测价值。结果 本研究共纳入318名患者，总25(OH)D(OR=0.866,95%CI:0.834～0.899,P<0.001)、生物可利用25(OH)D(OR=0.775,95%CI:0.655～0.917,P=0.003)和甲状旁腺素(OR=1.909,95%CI:0.852～0.969,P=0.004)与康复效果有关。ROC曲线分析结果显示，总25(OH)D、生物可利用25(OH)D和甲状旁腺素的曲线下面积分别为0.826、0.644和0.579。结论 高总25-(OH)D、高生物可利用25(OH)D、低甲状旁腺素水平促进老年髋部脆性骨折术后功能恢复。更多还原

【Abstract】 Objective To investigate the effect of bioavailable 25-(OH) Dand parathyroid hormone levels on functional recovery in elderly patients with brittle hip fractures after surgery. Methods A prospective cohort study of 318 adult patients with hip fractures from May 2017 to November 2021 in our hospital was enrolled. Levels of total 25-(OH)D, parathyroid hormone, calcium, albumin, and vitamin D-binding protein were measured. Self-designed questionnaires were collected. The bioavailable 25-(OH)D levels were calculated. A multivariate logistic regression model was used to analyze the association between bioavailable 25-(OH)D and parathyroid hormone levels and functional outcome in the elderly with fragile hip fractures. Receiver Operating Characteristic(ROC) was used to investigate the predictive value of bioavailable 25-(OH) D and parathyroid hormone levels, and postoperative function in the elderly with fragile hip fractures. Results A total of 318 patients were enrolled in this study. Total 25-(OH)D level(OR=0.866,95% CI: 0.834-0.899, P<0.001), bioavailable 25-(OH)D level(OR=0.775,95% CI: 0.655-0.917, P=0.003), and parathyroid hormone level(OR=1.909,95% CI: 0.852-0.969, P=0.004) were associated with rehabilitation outcomes. ROC curve analysis showed that the areas under the curve of total 25-(OH)D, bioavailable 25-(OH)D, and parathyroid hormone were 0.826, 0.644 and 0.579, respectively. Conclusion High total 25-(OH)D level, high bio-available 25-(OH) D level, and low parathyroid hormone level promote functional recovery after hip fracture surgery in the elderly.更多还原