血流变学指标及血清学指标在骨折延迟愈合患者中的临床意义

目的:探讨血流变学和血清学指标在骨折延迟愈合患者中的变化及其临床意义。方法:随机选取2010年1月~2016年6月在我院进行手术治疗的骨折延迟愈合及骨折正常愈合患者各90例,分别为观察组与对照组,对比分析两组患者术后第1、8、12周时血清可溶性血管细胞黏附分子1(sVCAM-1)、胰岛素样生长因子1(IGF-1)、血小板衍生生长因子(PDGF)及人可溶性细胞间黏附分子1(sICAM-1)和红细胞刚性指数、红细胞聚集指数、血浆黏度的差异。结果:术后第1、8、12周两组血清学及血流变学各指标整体相比差异均具有统计学意义(均P0.05),且组内两两比较均具有统计学差异(均P0.05)。术后8、12周观察组血清s ICAM-1、sVCAM-1、红细胞刚性指数、红细胞聚集指数、血浆黏度均高于对照组,而血清PDGF、IGF-1均低于对照组,比较差异均具有统计学意义(均P0.05)。结论:骨折患者血清sICAM-1、PDGF、IGF-1、sVCAM-1及红细胞刚性指数、红细胞聚集指数、血浆黏度水平会随着病程进展发生变化,并且血清sICAM-1、sVCAM-1及红细胞刚性指数、红细胞聚集指数、血浆黏度水平的升高,血清PDGF、IGF-1水平的降低可能是引起骨折延迟愈合的重要因素,对于骨折患者的临床治疗具有重要临床意义。

Clinical Significance of Hemorheological Indexes and Serological Indexes in Patients with Delayed Fracture Healing

ABSTRACT Objective: To explore the changes of hemorheology indexes and serological indexes in patients with delayed fracture healing and its clinical significance. Methods: 90 patients with delayed fracture healing and 90 patients with normal fracture healing who were treated with surgery in our hospital from January 2010 to June 2016 were randomly selected, they were divided into the observation group and the control group respectively. Then compared the serum soluble vascular cell adhesion molecule-1(sVCAM-1), insulin-like growth factor-1(IGF-1), platelet derived growth factor(PDGF), soluble intercellular adhesion molecule-1(sICAM-1), erythrocyte rigidity index, erythrocyte aggregation index, plasma viscosity of two groups in the 1st, 8th, 12th weeks after surgery. Results: The serological indexes and hemorheological indexes in two groups were overall compared in the 1st, 8th, 12th weeks after surgery, the differences were statistically significant(both P<0.05), and the pairwise comparison of within each groups were statistically significant(both P<0.05). The serum sVCAM-1, sICAM-1, erythrocyte rigidity index, erythrocyte aggregation index, plasma viscosity of the observation group were higher than those of the control group in the 8th, 12th weeks after surgery, while the serum PDGF, IGF-1 of the observation group were lower than those in the control group, the differences were statistically significant(both P<0.05). Conclusion: The sICAM-1, PDGF, IGF-1, sVCAM-1, erythrocyte rigidity index, erythrocyte aggregation index, plasma viscosity level of patients with fracture will change alone with the disease progresses, the rise of serum sICAM-1, sVCAM-1, erythrocyte rigidity index, erythrocyte aggregation index,plasma viscosity, as well as the drop of serum PDGF, IGF-1 may be the important factors induced delayed fracture healing, which has important clinical significance for the treatment of patients with fracture.