血清25OHD、甲状旁腺激素水平与老年骨质疏松症病人全髋关节置换术预后的相关性

doi:10.3969/j.issn.1003-9198.2021.12.012

摘要/Abstract

摘要： 目的探讨血清25羟维生素D(25OHD)、甲状旁腺激素(PTH)水平与老年骨质疏松症(OP)病人全髋关节置换术(THA)预后的相关性。方法回顾性分析2017年10月至2019年10月在我院行THA的147例髋骨骨折病人的临床资料,术前行骨密度检查,117例确诊为OP。术后6个月,根据Harris评分将OP病人分为预后良好组(89例)和预后不良组(28例),比较2组的一般临床资料和生化指标、25OHD、PTH水平。采用多因素Logistic回归分析影响老年OP病人THA预后的独立危险因素,采用Pearson相关系数描述血清25OHD、PTH水平与Harris评分之间的相关性。结果预后不良组年龄、术后关节脱位、术中出血量、入院时血清PTH水平高于预后良好组,入院时骨密度、血清25OHD水平低于预后良好组(P＜0.05);Logistic回归分析显示,高龄、术后关节脱位、入院时血清低25OHD水平、高PTH水平是影响老年OP病人THA预后的独立危险因素(OR=3.785、5.652、1.657、3.271)。OP病人骨密度、血清25OHD水平均与Harris评分呈正相关(r=0.621、0.764),血清PTH水平与Harris评分呈负相关(r=-0.557)。结论血清低水平25OHD、血清高水平PTH是影响老年OP病人THA预后的独立危险因素,可以作为预测老年OP病人THA预后的参考指标。

关键词: 25羟维生素D, 甲状旁腺激素, 骨质疏松症, 全髋关节置换术, 预后

Abstract: Objective To investigate the correlation between the serum level of 25-hydroxyvitamin D (25OHD), parathyroid hormone (PTH) and the prognosis of total hip arthroplasty (THA) in the elderly patients with osteoporosis (OP). Methods The clinical data of 147 hip fracture patients who underwent THA surgery in our hospital from October 2017 to October 2019 were retrospectively analyzed. Bone mineral density (BMD) examination was performed before operation, and 117 patients were diagnosed as OP. Six months after surgery, the OP patients was divided into good prognosis group (89 cases) and poor prognosis group (28 cases) according to Harris score. The general clinical data and biochemical indicators including 25OHD, PTH of the two groups were compared. The multivariate Logistic regression analysis was used to analyze the independent risk factors affecting the prognosis of THA in the elderly patients with OP. The correlation between serum levels of 25OHD, PTH and Harris score was analyzed by Pearson correlation. Results The age, postoperative joint dislocation, intraoperative blood loss, and serum level of PTH at admission in the poor prognosis group were higher than those in the good prognosis group, and the BMD, serum level of 25OHD at admission were lower than those in the good prognosis group (P<0.05); Logistic regression showed that old age, postoperative joint dislocation, low serum level of 25OHD and high serum level of PTH at admission were independent risk factors that affecting the prognosis of THA in the elderly patients with OP (OR=3.785, 5.652, 1.657, 3.271). Pearson analysis showed that BMD and 25OHD level were positively correlated with Harris score (r=0.621, 0.764), and PTH level was negatively correlated with Harris score (r=-0.557). Conclusions Low serum level of 25OHD and high serum level of PTH are independent risk factors affecting the prognosis of the elderly patients with OP after THA, and can be used as reference indicators for predicting the prognosis of the elderly patients with OP after THA.

Key words: 25-hydroxyvitamin D, parathyroid hormone, osteoporosis, total hip arthroplasty, prognosis

中图分类号:

R 683.42

张治水, 魏志凌, 王玉景, 崔鹏. 血清25OHD、甲状旁腺激素水平与老年骨质疏松症病人全髋关节置换术预后的相关性[J]. 实用老年医学, 2021, 35(12): 1258-1261.

ZHANG Zhi-shui, WEI Zhi-ling, WANG Yu-jing, Cui Peng. Correlation of serum levels of 25OHD and parathyroid hormone with prognosis of elderly patients with osteoporosis receiving total hip arthroplasty[J]. Practical Geriatrics, 2021, 35(12): 1258-1261.

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