创伤性骨折血清ALP、OPG表达与Th1/Th2平衡的相关性分析

摘要 目的：探讨创伤性骨折血清碱性磷酸酶（ALP）、骨保护素（OPG）表达与辅助性T细胞1（Th1）/辅助性T细胞2（Th2）平衡的相关性。方法：选取我院2019年2月到2022年12月收治的80例创伤性骨折患者作为研究对象，将其分为观察组，另选取同期来我院体检的80名健康志愿者作为对照组。抽取观察组患者入院后第二天清晨空腹静脉血和对照组清晨空腹静脉血，检测ALP、OPG、Th1、Th2表达水平，并分析血清ALP、OPG表达与Th1/Th2平衡的相关性。术后12个月后对观察组80例患者进行随访，依照患者骨折愈合程度将其分为骨折愈合组（n=54）和延迟愈合组（n=26），对比两组患者临床一般情况与ALP、OPG、Th1/Th2表达水平，并分析创伤性骨折患者骨折愈合情况影响的多因素。结果：观察组与对照组ALP、OPG表达与辅助性T细胞水平对比差异显著，观察组ALP、OPG、Th2水平明显高于对照组，Th1、Th1/Th2水平明显低于对照组（P＜0.05）；Spearman相关分析结果表明：血清ALP、OPG与Th1/Th2平衡呈负相关（P<0.05）；骨折愈合组和延迟愈合组患者性别、年龄、致伤原因、Th2对比无明显差异（P＞0.05），两组患者BMI、合并感染ALP、OPG、Th1、Th1/Th2水平对比差异显著（P＜0.05）；对上述单因素分析具有统计学差异指标进行赋值，多因素分析结果表明：ALP、OPG、Th2、Th1/Th2为影响创伤性骨折患者骨折愈合情况的独立影响因素（P＜0.05）。结论：创伤性骨折的发生会导致ALP、OPG水平升高，Th1/Th2平衡改变，患者血清ALP、OPG水平与Th1/Th2平衡关系具有明显相关性。另外，ALP、OPG、Th1、Th1/Th2水平变化可影响创伤性骨折患者术后骨折愈合水平。因此，临床上对于ALP、OPG水平升高，且Th1/Th2失衡患者需警惕骨折愈合不良的发生。

Correlation Analysis of Serum ALP, OPG Expression and Th1/Th2 Balance in Traumatic Fracture

ABSTRACT Objective: To investigate the correlation between the expression of serum alkaline phosphatase (ALP), osteoprotegerin (OPG) and the balance of helper T cell 1 (Th1)/helper T cell 2 (Th2) in traumatic fracture. Methods: 80 patients with traumatic fracture admitted to our hospital from February 2019 to December 2022 were selected as the study subjects and divided into observation group, and 80 healthy volunteers who came to our hospital for physical examination at the same time were selected as the control group. The fasting venous blood of the patients in the observation group and the control group in the morning after admission were taken to detect the expression levels of ALP, OPG, Th1 and Th2, and to analyze the correlation between the expression of serum ALP, OPG and Th1/Th2 balance. Eighty patients in the observation group were followed up 12 months after the operation. They were divided into fracture healing group (n=54) and delayed healing group (n=26) according to the degree of fracture healing. The clinical general situation and the expression level of ALP, OPG, Th1/Th2 in the two groups were compared, and the multiple factors affecting the fracture healing of traumatic fracture patients were analyzed. Results: There were differences in the expression of ALP, OPG and helper T cells between the observation group and the control group. The levels of ALP, OPG and Th2 in the observation group were higher than those in the control group, and the levels of Th1 and Th1/Th2 were lower than those in the control group (P<0.05); Spearman correlation analysis showed that serum ALP and OPG were negatively correlated with Th1/Th2 balance (P<0.05); There was no difference in sex, age, cause of injury and Th2 between the fracture healing group and the delayed healing group (P>0.05). There was difference in BMI, ALP, OPG, Th1 and Th1/Th2 levels between the two groups (P<0.05); The above univariate analysis has statistical difference indicators to assign values. The multi-factor analysis results show that ALP, OPG, Th2, Th1/Th2 are independent influencing factors affecting the fracture healing of traumatic fracture patients (P<0.05). Conclusion: The occurrence of traumatic fracture will lead to the increase of ALP and OPG levels and the change of Th1/Th2 balance. There is a significant correlation between the serum ALP and OPG levels of patients and Th1/Th2 balance. In addition, changes in the levels of ALP, OPG, Th1, Th1/Th2 can affect the level of postoperative fracture healing in patients with traumatic fracture. Therefore, clinically, patients with elevated ALP and OPG levels and Th1/Th2 imbalance should be alert to the occurrence of poor fracture healing.