髋关节置换围术期血清PCT、BMP2水平与术后髋关节功能恢复的关系

摘要

Objective To investigate the relationship between perioperative serum procalcitonin (PCT),bone morphogenetic protein 2 (BMP2) and postoperative recovery of hip function for patients with hip replacement.Methods A total of 148 patients with femoral neck fractures who underwent hip replacement from January 2013 to October 2014 in Puning People's Hospital,were randomly selected as the observation group,and 30 healthy who underwent physical examination during the same period were selected as the control group.The serum levels of PCT and BMP2 were detected by enzyme-linked immunosorbent assay (ELISA) before the operation and 1,3,5,7,14 days after the operation.Recovery of hip function was evaluated by Harris hip score at 1,3,6 months postoperatively.Pearson correlation analysis was applied to analyze the relationship between perioperative serum PCT,BMP2 levels and postoperative recovery of hip joint function.Results The levels of serum PCT and BMP2 in the observation group were higher than those in the control group at the different time-points (P <0.05).In observation group,preoperative serum levels of PCT and BMP2 were higher than those at 3,5,7 and 14 d postoperatively (P <0.05).Harris hip score after 6 months was as follows: 69 excellent,51 good,22 fair and 6 poor.The levels of serum PCT in the patients who evaluated as good and excellent hip function were lower,while levels of BMP2 were higher when compared with the patients with fair or poor hip function (P <0.05); Postoperative function of hip joint was negatively correlated with serum PCT levels,while was positively correlated with serum BMP2 levels (P <0.05).Conclusion For patients with hip replacement,serum PCT,BMP2 levels can be used as reference indexes to evaluate the recovery of hip function,which patients with high serum PCT and low serum BMP2 may show poor hip function recovery.%目的 探讨髋关节置换围术期血清降钙素原(PCT)和骨形态发生蛋白2(BMP2)水平与术后髋关节功能恢复的关系.方法随机选取2013年1月至2014年10月在普宁市人民医院行髋关节置换术的148例股骨颈骨折患者作为观察组,另选取30例同期健康体检者作为对照组.采用酶联免疫吸附法(ELISA)检测两组术前,术后1、3、5、7、14 d血清PCT和BMP2水平;术后1、3、6个月按Harris评分评价观察组髋关节功能恢复情况;采用Pearson相关性分析评估患者围术期血清PCT和BMP2水平与术后髋关节功能恢复的关系.结果 观察组术前,术后1、3、5、7、14 d血清PCT和BMP2水平均高于对照组(P<0.05).观察组术后3、5、7、14 d血清PCT和BMP2水平均较术前降低(P<0.05).术后6个月髋关节功能优、良、可、差分别为69、51、22、6例.髋关节功能优良者手术前后各时相点血清PCT水平均较髋关节功能中差者低,而血清BMP2水平则较高(P<0.05);术后髋关节功能与围术期血清PCT水平呈负相关(P<0.05),与血清BMP2水平呈正相关(P<0.05).结论 血清PCT和BMP2水平可作为评价髋关节置换术后患者髋关节功能恢复的参考指标,围术期血清PCT水平较高而BMP2水平较低者术后髋关节功能恢复较差.