Changes of serum Hcy and 25(OH)D levels and their relationship with cognitive function in elderly patients with femoral neck fracture and hip replacement
Objective To investigate the changes of serum homocysteine and 25(OH)D levels and their relationship with cognitive function in elderly patients with femoral neck fracture and hip replacement.Methods 120 elderly patients with femoral neck fracture from January 2020 to January 2023 underwent hip re⁃placement were selected as the study objects.Based on whether cognitive dysfunction occurred or not after sur⁃gery,they were divided into cognitive dysfunction group(n=33)and normal cognitive function group(n=87).Serum Hcy and 25(OH)D levels were detected within 24 hours after admission.Serum Hcy and 25(OH)D levels were compared between the two groups.The diagnostic value of serum Hcy and 25(OH)D in patients with femo⁃ral neck fracture and hip replacement was explored by ROC.The related factors affecting postoperative cognitive dysfunction were analyzed by multivariate logistic regression.Results The serum Hcy level in the cognitive dysfunction group was higher,and the 25(OH)D level was lower compared with the normal cognitive function group(P<0.05).ROC curve analysis shows that,the area under the curve of serum Hcy,25(OH)D and 25(OH)D were 0.841,0.865 and 0.918 respectively in the diagnosis of cognitive impairment in the elderly patients with femoral neck fracture after hip replacement.Age≥72.65 old,CRP≥23.25 mg/L,HIF⁃1α≥655.41 ng/mL,Hcy≥15.44 μmoL/L,25(OH)D<43.52 nmoL/L were risk factors for cognitive impairment in elderly patients with femoral neck fracture and hip replacement(P<0.05).Conclusion Serum Hcy levels increased while serum 25(OH)D levels decreased in elderly patients with femoral neck fracture and hip replacement.Both are closely related to postoperative cognitive dysfunction and are independent risk factors for postoperative cognitive dysfunction.
Femoral neck fractureHip replacementHomocysteine25-hydroxyvitamin D
万方数据
维普
