绝经后妇女椎体骨折患者骨转换生化标志物水平与术后再发骨折的关系研究

摘要

Objective To explore the relationship between biochemical markers of bone turnover and postoperative recurrence fracture in postmenopausal women with vertebral fracture.Methods The clinical data of 1 82 postmenopausal women With vertebral fractures were analyzed retrospectively.Patients with recurrent vertebral fractures after operation were selected as the observation group (n=138).Patients without recurrent vertebral fractures were enrolled in the control group (n=44).The serum levels of β-isomeric type Ⅰ collagen cross-linked-telopeptide (β-CTX) and type Ⅰ procollagen amino terminal propeptide molecule (P1NP) were detected.The results of the two groups were observed and compared,and the influencing factors of postoperative recurrent vertebral fractures were analyzed by univariate and multivariate logistic regression.Results There were significant differences between the two groups in age,menopause years,β-CTX and P1NP (P＜0.05).The two classification Logistic regression analysis and the dependent variable of postoperative recurrent vertebral fracture or not showed that the age,menopause years,β-CTX and P1NP contents were the risk factors of postoperative recurrent vertebral fractures when without age correction.And after age correction,the BMI index,BMD,β-CTX and P1NP contents were the risk factors for postoperative recurrent fractures.After age correction,the multivariate Logistic regression analysis including the P＜0.30 factor,the results showed that the changes of β-CTX and P1NP contents were independent risk factors of recurrent vertebral fractures.Conclusions High β-CTX and P1NP contents are independent risk factors for postoperative recurrent vertebral fractures in postmenopausal women with vertebral fractures,and timely detection of β-CTX and P1NP contents and intervention measures for postmenopausal women with vertebral fracture can help reduce the risk of vertebral fractures.%目的 探讨绝经后妇女椎体骨折患者骨转换生化标志物水平与术后再发骨折的关系.方法 回顾性分析182例绝经后妇女椎体骨折患者的临床资料,将术后再次发生椎体骨折患者作为观察组(n=138),术后未再发发生椎体骨折患者作为对照组(n=44),检测患者血清中β-异构Ⅰ型胶原交联羧基末端肽(β-CTX)和Ⅰ型原胶原分子氨基端前肽(P1NP)含量,观察比较两组患者的一般资料,并采用单因素和多因素Logistic回归分析术后再发椎体骨折影响因素.结果 两组患者在年龄、绝经年限、β-CTX和P1NP等方面比较,差异具有统计学意义(P＜0.05),采用二分类Logistic回归分析,以术后是否再发生椎体骨折为因变量,结果显示,未经年龄校正前,年龄、绝经年限、β-CTX和P1NP含量为术后再发椎体骨折的风险因素,而经年龄校正后,BMI指数、BMD、β-CTX和P1NP含量为术后再发骨折的风险因素.经年龄校正后将P＜0.30的因素纳入多因素Logistic回归分析发现,β-CTX和P1NP含量变化为再发椎体骨折的独立危险因素.结论 高β-CTX和P1NP含量是绝经后妇女椎体骨折患者术后再发椎体骨折的独立危险因素,对于绝经后妇女椎体骨折患者术后进行β-CTⅨ和P1NP含量及时检测并采取干预措施,有助于降低椎体骨折发生风险.