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目的探讨胸、腰椎骨质疏松性骨折患者椎体骨铁含量、血清铁蛋白与骨密度的相关性。方法回顾性分析2008年1月至2014年12月243例在苏州市第七人民医院因胸腰椎椎体骨折并接受手术治疗的患者的临床资料,其中男91例,女152例;年龄50~81岁,平均年龄62.5岁。患者入院后第2天留空腹血清标本测定血清铁蛋白和骨代谢指标并测量椎体骨密度;根据椎体骨密度检测值分为骨量减少组(-2.50.05),资料具有可比性。各变量与骨密度Pearson相关分析结果显示年龄、骨铁、血清铁蛋白、Ⅰ型原胶原氨基端延长肽、Ⅰ型胶原C端肽β降解产物与股骨颈骨密度相关系数r值分别为-0.712、-0.348、-0.323、-0.236、-0.227,与L_(1-4)骨密度相关系数r值分别-0.541、-0.206、-0.213、-0.184、-0.191,均呈负相关(P<0.05);体质量、体质量指数、转铁蛋白、总铁结合力与股骨颈骨密度相关系数r值分别为0.257、0.237、0.185、0.163,与L_(1-4)骨密度相关系数r值分别为0.361、0.335、0.204、0.197,均呈正相关(P<0.05)。骨铁、血清铁蛋白可进入股骨颈及腰椎L_(1-4)骨密度回归模型,股骨颈R~2=0.388,L_(1-4)R~2=0.374;骨铁和血清铁蛋白与腰椎骨密度呈负相关。结论胸腰椎骨质疏松性椎体骨折患者,椎体骨铁含量及血清铁蛋白含量越高,骨密度越低;骨铁及血清铁蛋白含量可能是胸腰椎骨质疏松性椎体骨折发生的危险因素之一。
Objective To investigate the relationship between vertebral bone iron content, serum ferritin and bone mineral density in patients with thoracic and lumbar osteoporotic fractures. Methods The clinical data of 243 patients with thoracolumbar vertebral fractures undergoing surgery in the Seventh People’s Hospital of Suzhou from January 2008 to December 2014 were retrospectively analyzed. There were 91 males and 152 females, aged 50 ~ 81 years old, average age 62.5 years old. On the second day after admission, the patients were given fasting serum samples for determination of serum ferritin and bone metabolism index and vertebral body BMD. According to the BMD of vertebral body, the patients were divided into osteopenia group (-2.5 0.05). The data were comparable. Pearson correlation analysis between each variable and bone mineral density showed that the correlation coefficient r of age, bone iron, serum ferritin, type Ⅰ procollagen N-terminal proline peptide, type Ⅰ collagen C terminal peptide β degradation product and femoral neck BMD were -0.712 , -0.348, -0.323, -0.236 and -0.227, respectively, were negatively correlated with the r values of BMD of L_ (1-4) -0.541, -0.206, -0.213, -0.184 and -0.191 ), Body weight, body mass index, transferrin, total iron binding capacity and femoral neck BMD r values were 0.257,0.237,0.185,0.163, respectively, and L_ (1-4) BMD r values 0.361,0.335,0.204,0.197, were positively correlated (P <0.05). Bone iron and serum ferritin could enter the L_ (1-4) BMD regression model of the femoral neck and lumbar spine. The femoral neck R ~ 2 = 0.388, L_ (1-4) R ~ 2 = 0.374; Lumbar bone mineral density was negatively correlated. Conclusions In patients with thoracolumbar osteoporotic vertebral fractures, the higher the content of iron and the content of serum ferritin, the lower the bone mineral density. The content of osteocalcin and serum ferritin may be the occurrence of osteoporotic vertebral fracture One of the risk factors.