糖尿病合并骨折患者围术期血浆IGF-1、NPY与BAP的变化

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摘要目的研究糖尿病合并骨折的患者围术期血浆胰岛素样生长因子-1(insulin-like growth factor-1，IGF-1)、神经肽Y(neuropeptide Y，NPY)及骨碱性磷酸酶(bone alkaline phosphatase，BAP)的含量变化，探讨其对糖尿病患者骨折愈合的影响。方法回顾性分析2018年9月至2019年3月在蛛网膜下隙麻醉下行下肢骨折手术患者70例，根据是否有2型糖尿病分为糖尿病组和对照组，两组各35例。糖尿病组男16例，女19例；平均年龄(59.80±8.33)岁。对照组男18例，女17例；平均年龄(54.37±13.07)岁。分别于术前、术毕24 h抽取肘静脉血2 mL，分离血浆，用酶联免疫吸附法测定血浆中IGF-1、NPY及BAP的含量。结果糖尿病组和对照组血浆IGF-1、NPY及BAP含量在术后24 h均较术前显著升高(P＜0.05)。糖尿病组术前、术后血浆IGF-1含量均低于对照组(P＜0.05)；术前血浆NPY和BAP含量明显高于对照组(P＜0.05)，而术后血浆NPY升高幅度(差值)明显低于对照组(P＜0.05)。结论 IGF-1、NPY及BAP均参与调节骨愈合修复过程；糖尿病患者骨折术后早期IGF-1降低、NPY升高幅度较低和BAP持续升高可能与骨折延迟愈合相关。

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	李琪 1
	李琳 1
	孟珊珊 1
	张林忠 2*

关键词 ：糖尿病, 胰岛素样生长因子-1, 神经肽Y, 骨碱性磷酸酶, 骨折愈合

Abstract：Objective To study the changes of perioperative plasma levels of insulin-like growth factor-1 (IGF-1)，neuropeptide Y (NPY) and bone alkaline phosphatase (BAP) in diabetic patients with fracture，and to explore their effects on fracture healing in diabetic patients.Methods Seventy patients with lower limb fracture surgery under selective subarachnoid anesthesia from September 2018 to March 2019 were selected.According to whether there was type 2 diabetes，they were divided into the diabetes group and the control group，with thirty-five patients in each group.Diabetes mellitus group included 16 males and 19 females. The mean age was (59.80±8.33) years old.The control group had 18 males and 17 females.The mean age was (54.37±13.07) years old.Two milliliter of elbow-vein blood was extracted pre-operation and 24 hours after surgery，respectively.Plasma was separated and the contents of IGF-1，NPY and BAP in plasma were determined by enzyme linked immunosorbent assay (ELISA).Results The plasma levels of IGF-1，NPY and BAP were significantly higher at 24 hours after surgery than before surgery in the diabetic group and the control group (P＜0.05).The plasma level of IGF-1 in diabetic group was lower than that in control group before and after surgery (P＜0.05).Before surgery，the plasma NPY and BAP levels were significantly higher than that of control group (P＜0.05).After surgery，the increase of NPY in plasma was significantly lower in the diabetic group than that in the control group (P＜0.05).Conclusion IGF-1，NPY and BAP are all involved in the regulation of bone healing repair process.The decrease of IGF-1，the smaller degree of NPY increase and the continuous increase of BAP may be related to delayed bone healing during early stage after fracture surgery in diabetic patients.

Key words： diabetes insulin-like growth factor-1 neuropeptide Y bone alkaline phosphatase fracture healing

基金资助:山西医科大学科技创新基金(01201513)

通讯作者: 张林忠

作者简介: 李琪(1993－ )，女，研究生在读，山西医科大学麻醉学院，030001。

引用本文:

李琪 1，李琳 1，孟珊珊 1，张林忠 2*. 糖尿病合并骨折患者围术期血浆IGF-1、NPY与BAP的变化[J]. 实用骨科杂志, 2021, 27(7): 607-637.
Li Qi，Li Lin，Meng Shanshan，et al. Changes of Plasma IGF-1，NPY and BAP in Diabetic Patients with Fracture During Perioperative Period. sygkzz, 2021, 27(7): 607-637.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I7/607

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