骨质疏松椎体压缩性骨折PKP术后肺部感染患者血清IL-6、CRP水平及预后分析
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摘要
目的探讨骨质疏松椎体压缩性骨折(OVCF)经皮椎体球囊内扩张椎体成形术(PKP)术后肺部感染患者血清白细胞介素6(IL-6)、C-反应蛋白(CRP)水平及对预后的影响。方法回顾性选择2016年11月至2017年11月淮北市人民医院收治的64例骨质疏松椎体压缩性骨折患者为研究对象,对其行PKP治疗。观察PKP术后肺部感染情况,分析肺部感染对IL-6、CRP、肿瘤坏死因子α(TNF-α)、免疫细胞CD4+、CD8+、免疫球蛋白G(Ig G)、Ig A、Ig M及预后的影响。结果 64例骨质疏松椎体压缩性骨折PKP术后患者中,发生肺部感染12例,感染率为18. 75%;感染患者血清中IL-6、CRP、TNF-α水平明显高于非感染患者,有统计学差异(P <0. 05);感染患者CD4+细胞及Ig A水平与非感染患者比较无统计学差异(P> 0. 05);感染患者CD8+细胞及Ig G、Ig M水平明显低于非感染患者,有统计学差异(P<0. 05);非感染患者预后Harris评分优秀率明显高于感染患者,有统计学差异(P <0. 05);年龄> 65岁、术前合并慢性阻塞性肺疾病(COPD)、术前合并糖尿病、美国麻醉医师协会(ASA)分级过高是骨质疏松椎体压缩性骨折PKP术后肺部感染的危险因素(P <0. 05)。结论骨质疏松椎体压缩性骨折患者PKP术后肺部感染可上调血清中IL-6、CRP水平,影响患者预后,临床中应给予相应措施降低术后肺部感染发生率。
Objective To investigate the effect of pulmonary infection on interleukin-6( IL-6),C-reactive protein( CRP) and prognosis in patients with osteoporotic vertebral compression fracture( OVCF) after percutaneous kyphoplasty( PKP). Methods 64 OVCF patients underwent PKP treatment in our hospital from November 2016 to November 2017 were selected,and the incidence rate of the postoperative pulmonary infection was recorded. Then the effects of pulmonary infection on IL-6,CRP,tumor necrosis factor-α( TNF-α),immune cells CD4+,CD8+,immunoglobulin G( Ig G),Ig A,Ig M and prognosis were analyzed. Results The incidence rate of the postoperative pulmonary infection was 18. 75%( 12/64); The serum levels of IL-6,CRP and TNF-α of infected patients were significantly higher than those in non-infected patients( P < 0. 05),while no difference was found in the levels of the CD4+and Ig A( P > 0. 05). The levels of CD8+cells,Ig G and Ig M in infected patients were significantly lower than those in non-infected patients( P < 0. 05). The excellent rate of Harris score in non-infected patients was significantly higher than that in infected patients,with statistical difference( P < 0. 05). Age > 65 year-old,preoperative chronic obstructive pulmonary disease( COPD),preoperative diabetes,and high grade of American Society of Anesthesiologists( ASA) were risk factors for pulmonary infection after PKP in OVCF patients( P < 0. 05). Conclusion OVCF patients underwent PKP treatment with pulmonary infection have elevated serum levels of IL-6 and CRP,which can affect the prognosis of patients,so corresponding measures should be taken to reduce the incidence of pulmonary infection after PKP.
Objective To investigate the effect of pulmonary infection on interleukin-6( IL-6),C-reactive protein( CRP) and prognosis in patients with osteoporotic vertebral compression fracture( OVCF) after percutaneous kyphoplasty( PKP). Methods 64 OVCF patients underwent PKP treatment in our hospital from November 2016 to November 2017 were selected,and the incidence rate of the postoperative pulmonary infection was recorded. Then the effects of pulmonary infection on IL-6,CRP,tumor necrosis factor-α( TNF-α),immune cells CD4+,CD8+,immunoglobulin G( Ig G),Ig A,Ig M and prognosis were analyzed. Results The incidence rate of the postoperative pulmonary infection was 18. 75%( 12/64); The serum levels of IL-6,CRP and TNF-α of infected patients were significantly higher than those in non-infected patients( P < 0. 05),while no difference was found in the levels of the CD4+and Ig A( P > 0. 05). The levels of CD8+cells,Ig G and Ig M in infected patients were significantly lower than those in non-infected patients( P < 0. 05). The excellent rate of Harris score in non-infected patients was significantly higher than that in infected patients,with statistical difference( P < 0. 05). Age > 65 year-old,preoperative chronic obstructive pulmonary disease( COPD),preoperative diabetes,and high grade of American Society of Anesthesiologists( ASA) were risk factors for pulmonary infection after PKP in OVCF patients( P < 0. 05). Conclusion OVCF patients underwent PKP treatment with pulmonary infection have elevated serum levels of IL-6 and CRP,which can affect the prognosis of patients,so corresponding measures should be taken to reduce the incidence of pulmonary infection after PKP.
引文
[1]闫江涛,闫长红,赵松海,等.经皮椎体成形术治疗骨质疏松性椎体压缩性骨折手术时机与术后疼痛缓解关系的回顾性研究[J].临床和实验医学杂志,2017,16(18):1832-1834.
[2]蔡晓燕,董光富.脂代谢及血清骨钙素水平与骨质疏松症的相关性分析[J].中国骨质疏松杂志,2016,22(6):711-712,730.
[3]王振斌,涂来勇,顾文飞,等. PKP与PVP治疗轻中度骨质疏松性椎体压缩性骨折的临床疗效比较[J].浙江医学,2016,38(23):1896-1898,1905.
[4]秦佳霖,冯德宏,赵继军,等.稳定机制在经皮球囊扩张椎体成形术治疗椎体压缩性骨折疗效中的作用[J].中国矫形外科杂志,2016,24(10):870-873.
[5] Cosman F,Crittenden DB,Adachi JD,et al. Romosozumab Treatment in Postmenopausal Women with Osteoporosis[J]. N Engl J Med,2016,375(16):1532-1543.
[6] Eun AS,Nam RK,Seon PJ,et al. Early Bone Marrow Edema Pattern of the Osteoporotic Vertebral Compression Fracture:Can Be Predictor of Vertebral Deformity Types and Prognosis[J]? J Korean Neurosurg Soc,2016,59(2):137-142.
[7] Morris J,Job A,Ahmed A,et al. Poster 401 Optimizing the Process Flow Chart for the Inpatient Management of Osteoporotic Vertebral Compression Fractures(OVCF)[J]. PM R,2016,8(9):S292-S292.
[8] Huang ZF,Xiao SX,Liu K,et al. Effectiveness Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in Treatment of Primary Osteoporotic Vertebral Compression Fractures[J]. Pain Physician,2019,22(1):63-68.
[9] Liu T,Li Z,Su Q,et al. Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty surgery[J]. Medicine(Baltimore),2017,96(25):e7216.
[10]刘军,李旭升,甄平,等. RA伴骨质疏松患者行同期双侧髋关节置换疗效分析[J].实用骨科杂志,2017,23(2):105-109,113.
[11]武志刚,郑宏伟,高彦文,等. PVP与PKP对骨质疏松椎体压缩性骨折患者关节疼痛及关节功能影响的对比观察[J].山东医药,2017,57(12):77-79.
[12]张翠平,邵长周.炎症细胞因子与肺部感染关系的研究进展[J].中国临床医学,2018,25(1):132-136.
[13] Su F,Bai F,Zhang Z. Inflammatory Cytokines and Alzheimer's Disease:A Review from the Perspective of Genetic Polymorphisms[J].Neurosci Bull,2016,32(5):469-480.
[14] Jinrui D,Wupeng L,Yong PH,et al. Ribosomal Protein S3 Gene Silencing Protects Against Cigarette Smoke-Induced Acute Lung Injury[J]. Mol Ther Nucleic Acids,2018,12:370-380.
[15] Kristjansson SR,Nesbakken A,Jordhy MS,et al. Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer:A prospective observational cohort study[J]. Crit Rev Oncol Hematol,2010,76(3):208-217.
[2]蔡晓燕,董光富.脂代谢及血清骨钙素水平与骨质疏松症的相关性分析[J].中国骨质疏松杂志,2016,22(6):711-712,730.
[3]王振斌,涂来勇,顾文飞,等. PKP与PVP治疗轻中度骨质疏松性椎体压缩性骨折的临床疗效比较[J].浙江医学,2016,38(23):1896-1898,1905.
[4]秦佳霖,冯德宏,赵继军,等.稳定机制在经皮球囊扩张椎体成形术治疗椎体压缩性骨折疗效中的作用[J].中国矫形外科杂志,2016,24(10):870-873.
[5] Cosman F,Crittenden DB,Adachi JD,et al. Romosozumab Treatment in Postmenopausal Women with Osteoporosis[J]. N Engl J Med,2016,375(16):1532-1543.
[6] Eun AS,Nam RK,Seon PJ,et al. Early Bone Marrow Edema Pattern of the Osteoporotic Vertebral Compression Fracture:Can Be Predictor of Vertebral Deformity Types and Prognosis[J]? J Korean Neurosurg Soc,2016,59(2):137-142.
[7] Morris J,Job A,Ahmed A,et al. Poster 401 Optimizing the Process Flow Chart for the Inpatient Management of Osteoporotic Vertebral Compression Fractures(OVCF)[J]. PM R,2016,8(9):S292-S292.
[8] Huang ZF,Xiao SX,Liu K,et al. Effectiveness Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in Treatment of Primary Osteoporotic Vertebral Compression Fractures[J]. Pain Physician,2019,22(1):63-68.
[9] Liu T,Li Z,Su Q,et al. Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty surgery[J]. Medicine(Baltimore),2017,96(25):e7216.
[10]刘军,李旭升,甄平,等. RA伴骨质疏松患者行同期双侧髋关节置换疗效分析[J].实用骨科杂志,2017,23(2):105-109,113.
[11]武志刚,郑宏伟,高彦文,等. PVP与PKP对骨质疏松椎体压缩性骨折患者关节疼痛及关节功能影响的对比观察[J].山东医药,2017,57(12):77-79.
[12]张翠平,邵长周.炎症细胞因子与肺部感染关系的研究进展[J].中国临床医学,2018,25(1):132-136.
[13] Su F,Bai F,Zhang Z. Inflammatory Cytokines and Alzheimer's Disease:A Review from the Perspective of Genetic Polymorphisms[J].Neurosci Bull,2016,32(5):469-480.
[14] Jinrui D,Wupeng L,Yong PH,et al. Ribosomal Protein S3 Gene Silencing Protects Against Cigarette Smoke-Induced Acute Lung Injury[J]. Mol Ther Nucleic Acids,2018,12:370-380.
[15] Kristjansson SR,Nesbakken A,Jordhy MS,et al. Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer:A prospective observational cohort study[J]. Crit Rev Oncol Hematol,2010,76(3):208-217.
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