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| 老年骨质疏松股骨粗隆骨折骨代谢与预后相关性研究 |
| Study on the correlation between bone metabolism indicators and prognosis in elderly patients with osteoporosis complicated with femoral condyle fracture |
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| DOI：10.3969/j.issn.1006-7108.2026.08.013 |
| 中文关键词: 老年骨质疏松症 股骨粗隆骨折 骨代谢 骨密度 并发症风险 |
| 英文关键词:elderly osteoporosis femoral trochanteric fracture bone metabolism bone mineral density complication risk |
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| 中文摘要: |
| 目的 探讨老年骨质疏松症(osteoporosis, OP)合并股骨粗隆骨折患者血清骨代谢标志物、维生素 D 及骨密度的水平变化，分析其与骨折严重程度、术后髋关节功能及并发症的相关性，为临床早期风险评估、预后判断及个体化干预提供依据。方法 回顾性选取2018年1月1日-2024年12月1日玉环市第二人民医院收治的432例老年OP患者，分为骨折组（212 例，合并股骨粗隆骨折）与对照组（220例，单纯OP）。检测血清Ⅰ型原胶原N-端前肽（PINP）、β-胶原特殊序列（β-CTX）、维生素D水平及腰椎骨密度，按维生素D水平行亚组分析；采用相关性分析及二元Logistic回归，探究各指标与骨折分型、髋关节功能、术后并发症的关联。结果 骨折组PINP、维生素D、骨密度显著低于对照组，β-CTX显著高于对照组（P<0.05）；维生素D缺乏组骨折Garden分型更严重、Harris髋关节功能评分更低、术后并发症发生率更高（P<0.05）。骨密度、PINP、维生素D与Harris髋关节功能评分呈正相关、与Garden分型呈负相关，β-CTX与之相反（P<0.05）。Logistic回归显示，骨密度、PINP、维生素D是术后并发症的保护因素，β-CTX是危险因素（P<0.05）。结论 老年OP合并股骨粗隆骨折患者存在显著骨代谢失衡、维生素D缺乏及骨量减少；PINP、β-CTX、维生素D及骨密度可有效评估骨折严重程度、预测术后并发症风险，为该类患者的临床预后判断与个体化防治提供客观参考。 |
| 英文摘要: |
| Objective To investigate the changes in serum bone metabolism markers, vitamin D levels, and bone mineral density in elderly patients with osteoporosis complicated with femoral trochanteric fractures, and to analyze their correlations with the severity of fractures, postoperative hip joint function, and complications. This study aims to provide a basis for early clinical risk assessment, prognosis judgment, and individualized intervention. Methods A retrospective study was conducted on 432 elderly patients with osteoporosis (OP) admitted from January 1, 2018 to December 1, 2024. They were divided into the fracture group (212 cases, with femoral trochanteric fractures) and the control group (220 cases, with simple OP). Serum levels of type I procollagen N-terminal propeptide (PINP), β-collagen specific sequence (β-CTX), vitamin D, and lumbar spine bone mineral density were measured. Subgroup analysis was performed based on vitamin D levels. Correlation analysis and binary Logistic regression were used to explore the associations of each indicator with fracture classification, hip joint function, and postoperative complications. Results The PINP, vitamin D, and bone mineral density in the fracture group were significantly lower than those in the control group, while β-CTX was significantly higher in the fracture group (P<0.05). The vitamin D deficiency group had more severe Garden fracture classification, lower Harris hip joint function score, and higher incidence of postoperative complications (P<0.05). Bone mineral density, PINP, vitamin D were positively correlated with Harris hip joint function score, and negatively correlated with Garden classification. β-CTX was opposite to these indicators (P<0.05). Logistic regression showed that bone mineral density, PINP, vitamin D were protective factors for postoperative complications, while β-CTX was a risk factor (P<0.05). Conclusion Elderly patients with OP complicated with femoral trochanteric fractures have significant bone metabolism imbalance, vitamin D deficiency, and bone loss. PINP, β-CTX, vitamin D, and bone mineral density can effectively evaluate the severity of fractures and predict the risk of postoperative complications. This provides objective references for the clinical prognosis judgment and individualized prevention and treatment of such patients. |
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