目的 探讨老年男性股骨转子间骨折患者围术期血清IL-6水平变化,为此类患者的炎症控制提供依据.方法 回顾分析2021年1月-2022年12月收治且符合选择标准的40例年龄≥60岁男性股骨转子间骨折患者临床资料,其中25例为非骨质疏松症患者(T值＞-2.5,A组),15例为骨质疏松症患者(T值≤-2.5,B组);另外根据年龄配比规则纳入40例年龄≥60岁健康男性作为对照(C组).3组受试者年龄、吸烟史、饮酒史、身体质量指数、合并症(高血压病和糖尿病)、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血尿素氮、肌酐和总蛋白等基线资料比较,差异均无统计学意义(P＞0.05).取C组受试者血清样本,A、B组患者术前及术后1、3、5、7 d的血清样本,ELISA法检测血清IL-6水平;采用Pearson相关分析A、B组所有患者围术期各时间点IL-6水平与T值的相关性.记录A、B组患者术后住院期间并发症发生情况和1年死亡率.结果 A、B组术前IL-6水平显著高于C组,B组显著高于A组,差异均有统计学意义(P＜0.05).A、B组患者术后1 d IL-6水平较术前显著升高,然后呈逐渐下降趋势,至术后7 d时降至接近术前水平;术后各时间点B组IL-6水平均显著高于A组,差异有统计学意义(P＜0.05).相关性分析示,A、B组所有患者围术期各时间点IL-6水平与T值均成负相关(P＜0.05).术后住院期间A组4例患者(16.0％)发生并发症,包括肺部感染2例、尿路感染1例、心力衰竭1例;B组3例患者(20.0％)发生并发症,包括肺部感染2例、消化道出血1例;两组并发症发生率比较差异无统计学意义(x2=0.104,P=0.747).A、B组分别有2例(8.0％)和4例(26.7％)于术后1年内死亡,两组死亡率比较差异无统计学意义(x2=2.562,P=0.109).结论 老年男性股骨转子间骨折患者术后早期血清IL-6水平显著增高,尤其在骨质疏松症患者中更为明显.围术期监测炎症状态并及时控制炎症反应,可降低并发症,改善术后生存状况.
Perioperative changes of serum interleukin 6 levels in elderly male patients with intertrochanteric fracture
Objective To investigate the perioperative changes in serum interleukin 6(IL-6)levels in elderly male patients with intertrochanteric fractures,and provide evidence for inflammatory control in this patient population.Methods The clinical data of 40 male patients aged more than 60 years with intertrochanteric fractures who met the selection criteria between January 2021 and December 2022 were retrospectively analyzed,including 25 non-osteoporosis patients(T value＞-2.5,group A)and 15 osteoporosis patients(T value≤-2.5,group B).In addition,40 healthy men aged more than 60 years old were included as controls(group C)according to the age matching rule.There was no significant difference in age,smoking history,drinking history,body mass index,complications(hypertension and diabetes),alanine aminotransferase,aspartate aminotransferase,blood urea nitrogen,creatinine,and total protein among the 3 groups(P＞0.05).Serum samples were collected from group C subjects and from groups A and B patients preoperatively and on postoperative days 1,3,5,and 7.IL-6 levels were measured using ELISA assay.Pearson correlation analysis was used to assess the relationship between IL-6 levels and T values at various time points in groups A and B.Postoperative complications during hospitalization and 1-year mortality rates were recorded for groups A and B.Results Preoperative IL-6 levels were significantly higher in groups A and B than in group C(P＜0.05),with group B being significantly higher than group A(P＜0.05).In groups A and B,IL-6 levels increased significantly on postoperative day 1 compared to preoperative levels and then gradually decreased,approaching preoperative levels by postoperative day 7.IL-6 levels in group B were significantly higher than those in group A at all postoperative time points(P＜0.05).Correlation analysis showed that IL-6 levels were negatively correlated with T values at all perioperative time points in all patients from groups A and B(P＜0.05).Complications occurred in 4 patients(16.0％)in group A,including 2 cases of pulmonary infection,1 case of urinary tract infection,and 1 case of heart failure,and in 3 patients(20.0％)in group B,including 2 cases of pulmonary infection and 1 case of gastrointestinal bleeding.There was no significant difference in the incidence of complications between the two groups(x2=0.104,P=0.747).There were 2 cases(8.0％)and 4 cases(26.7％)died within 1 year after operation in groups A and B,respectively,and there was no significant difference in 1-year mortality rates between the two groups(x2=2.562,P=0.109).Conclusion Serum IL-6 levels significantly increase in the early postoperative period in elderly male patients with intertrochanteric fractures,especially in those with osteoporosis.Monitoring the inflammatory state and promptly controlling the inflammatory response during the perioperative period,may reduce complications and improve postoperative survival in this patient population.
万方数据
维普
