中国组织工程研究

中国组织工程研究 ›› 2013, Vol. 17 ›› Issue (52): 9095-9100.doi: 10.3969/j.issn.2095-4344.2013.52.025

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    

老年髋部骨折的预后：白蛋白、淋巴细胞、血红蛋白之效应

王振恒1，方永超1，2，阚翔翔1，郭  亭1，赵建宁1   

  1. 1南京大学医学院临床学院，解放军南京军区南京总医院骨科，江苏省南京市   210002；2江苏省苏北人民医院骨科，江苏省扬州市   225001
  • 修回日期:2013-09-26 出版日期:2013-12-24 发布日期:2013-12-24
  • 通讯作者: 郭亭，博士，副主任医师，南京大学医学院临床学院，解放军南京军区南京总医院骨科，江苏省南京市 210002 guotingli@vip.sina.com
  • 作者简介:王振恒，男，1987年生，江苏省徐州市人，汉族，2011年徐州医学院毕业，医师，主要从事关节外科方面的研究。 wangzhenheng1987@163.com
  • 基金资助:

    国家自然科学基金项目(81000792) *；江苏省临床药学科技专项资助(BL2012002)*

Prognosis of hip fractures in elderly patients: Effects of albumin, lymphocyte and hemoglobin

Wang Zhen-heng1, Fang Yong-chao1, 2, Kan Xiang-xiang1, Guo Ting1, Zhao Jian-ning1   

  1. 1Department of Orthopedics, Nanjing General Hospital of Nanjing Military Command, Clinical School, Medical College, Nanjing University, Nanjing  210002, Jiangsu Province, China; 2Department of Orthopedics, Northern Jiangsu People’s Hospital, Yangzhou  225001, Jiangsu Province, China
  • Revised:2013-09-26 Online:2013-12-24 Published:2013-12-24
  • Contact: Guo Ting, Ph.D., Associate chief physician, Department of Orthopedics, Nanjing General Hospital of Nanjing Military Command, Clinical School, Medical College, Nanjing University, Nanjing 210002, Jiangsu Province, China guotingli@vip.sina.com
  • About author:Wang Zhen-heng, Physician, Department of Orthopedics, Nanjing General Hospital of Nanjing Military Command, Clinical School, Medical College, Nanjing University, Nanjing 210002, Jiangsu Province, China wangzhenheng1987@163.com
  • Supported by:

     the National Natural Science Foundation of China, No. 81000792*; the Clinical Pharmacy Technology Project of Jiangsu Province, No. BL2012002

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摘要：

背景：文献报道营养状况不良与老年人髋部骨折术后的死亡存在相关性，但国内此项研究尚未见报道。
目的：回顾性分析老年髋部骨折患者入院时血液白蛋白、淋巴细胞数和血红蛋白水平与预后的关系。
方法：纳入130例髋部骨折患者，年龄大于70岁，均采用人工全髋关节置换或人工双动头置换治疗。患者入院时测量白蛋白、淋巴细胞数及血红蛋白，置换后随访1年，或者随访至患者死亡，其中有效随访92例。采用 Kaplan-Meier法及Log-Rank检验进行生存分析，多因素Cox比例风险模型进行预后多因素分析。
结果与结论：92例患者中，20例(22%)白蛋白< 35 g/L，67例(73%)淋巴细胞数<1.5×106 L-1，56例(61%)血红蛋白< 120 g/L。Kaplan-Meier法分析提示，白蛋白正常患者(≥35 g/L)的生存率显著高于白蛋白减低患者(< 35 g/L)(P < 0.01)；淋巴细胞数正常(≥1.5×106 L-1)与淋巴细胞数减低(<1.5×106 L-1)患者的生存率差异无显著性意义(P > 0.05)；血红蛋白正常患者(≥120 g/L)的生存率显著高于血红蛋白减低患者(<120 g/L)(P < 0.05)。Cox多因素分析显示，白蛋白减低是老年髋部骨折患者死亡的独立预后因素。提示老年髋部骨折患者的预后与其营养状况密切相关，白蛋白及血红蛋白等常规的入院检验可作为判断患者预后的重要指标。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

关键词: 骨关节植入物, 骨与关节临床实践, 髋部骨折, 白蛋白, 淋巴细胞数, 血红蛋白, 死亡率, 国家自然科学基金

Abstract:

BACKGROUND: Studies have shown that malnutrition was associated with death of elder people after fracture of hip, but there were no above-mentioned reports in China.
OBJECTIVE: To retrospectively analyze the relationship of blood albumin, total lymphocyte count and hemoglobin levels to prognosis when elder patients with fracture of hip were on admission.
METHODS: 130 elderly patients with hip fractures aged ≥ 70 years were included underwent either total hip arthroplasty or bipolar arthroplasty. Admission serum albumin, total lymphocytecount and hemoglobin levels were recorded. The patients were followed up for 1 year or till the death. Survival data were available in 92 patients. Rates of survival were calculated by the Kaplan-Meier method and the Log-Rank test. Cox proportional hazard regression model received prognostic multivariate analysis.
RESULTS AND CONCLUSION: Of the 92 patients, albumin < 35 g/L in 20 cases (22%), total lymphocyte count < 1.5×106/L in 67 cases (73%), and hemoglobin < 120 g/L in 56 cases (61%). Kaplan-Meier method showed that the survival rate of patients with normal albumin (≥ 35 g/L) was significantly higher than those with reduced albumin (< 35 g/L) (P < 0.01). No significant difference was detected in the survival rate of patients with normal total lymphocyte count (≥ 1.5×106/L) and reduced total lymphocyte count (< 1.5×106/L) (P > 0.05). The survival rate of patients with normal hemoglobin (≥ 120 g/L) was significantly higher than those with decreased hemoglobin (< 120 g/L) (P < 0.05). Cox multivariate analysis displayed that albumin decrease is an independent prognostic factor for death of patients with hip fracture. Results indicated that the prognosis of elder patients with hip fracture was strongly associated with their nutritional conditions. Albumin and hemoglobin levels at admission can be considered as important indexes for judging patient’s prognosis.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

Key words: hip fracture, albumin, lymphocyte, hemoglobin, mortality

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