中国骨质疏松杂志

血清β-CTX、Cathe K、OPG对老年OPF患者术后骨折再发的预测价值

The predictive value of serum β-CTX, Cathe K and OPG on postoperative fracture recurrence in elderly patients with OPF

DOI：10.3969/j.issn.1006-7108.2022.02.009

中文关键词: 老年骨质疏松性骨折再发骨折 β-胶原降解产物组织蛋白酶K 骨保护素

英文关键词:osteoporotic fracture in the elderly New symptomatic fractures Beta collagen degradation products cathepsin K osteoprotegerin

基金项目:

作者	单位
王汉1* 黄友华1 符林雄1 李儒琳2	1. 中南大学湘雅医学院附属海口医院骨科中心，海南海口 570208 2. 琼海市人民医院骨外科，海南琼海 571400

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中文摘要:

目的探究血清β-胶原降解产物（β-CTX）、组织蛋白酶K（cathepsin K，Cathe K）和骨保护素（osteoprotegerin，OPG）对老年骨质疏松性骨折（osteoportic fracture，OPF）术后骨折再发的预测价值。方法选取2018年3月-2020年3月在中南大学湘雅医学院附属海口医院行经皮椎体成形术（percutaneous vertebroplasty，PVP）和经皮椎体后凸成形术（percutaneous kyphoplasty vertebroplasty，PKP）治疗的老年OPF患者120例，依据术后是否再发骨折分为再发骨折组（32例）和非再发骨折组（88例），检测并对比两组患者血清β-CTX、Cathe K、OPG水平及其他可能影响因素差异。采用Logistic回归分析明确影响老年OPF术后再发骨折的危险因素，并绘制受试者工作特征曲线（ROC）评价血清β-CTX、Cathe K、OPG水平对老年OPF患者再发骨折的预测价值。结果再发骨折组的骨折程度、血清β-CTX、Cathe K水平高于非再发骨折组，骨密度T值及血清OPG水平低于非再发骨折组（P＜0.05）。Logistic回归分析显示，骨折程度、骨密度T值、β-CTX、Cathe K、OPG均是影响老年OPF患者术后再发骨折的危险因素（P＜0.05）。ROC分析显示，血清β-CTX、Cathe K、OPG联合预测老年OPF患者术后再发骨折的灵敏度、特异度、AUC分别为87.50 %、60.23 %、0.859，均高于β-CTX、Cathe K、OPG单独预测。结论血清β-CTX、Cathe K、OPG在老年OPF术后再发骨折患者中的水平较高，是影响老年OPF术后再发骨折的危险因素，对老年OPF术后骨折再发的评估具有较高的临床价值。

英文摘要:

Objective To explore the predictive value of serum beta collagen degradation products (β-CTX), cathepsin K (Cathe K) and osteoprotegerin (OPG) levels in predicting the recurrence of fractures after senile osteoporotic fractures (OPF). Methods A total of 120 elderly OPF patients who underwent percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in Haikou Hospital Affiliated to Xiangya School of Medicine, Central South University from March 2018 to March 2020 were selected and divided into recurrent fracture group (32 cases) and non-recurrent fracture group (88 cases) according to whether postoperative fractures occurred. Serum levels of β-CTX, Cathe K, OPG and other possible influencing factors were detected and compared between the two groups. Logistic regression analysis was used to identify the risk factors for postoperative refracture in elderly patients with OPF, and receiver operating characteristic curve (ROC) was drawn to evaluate the predictive value of serum β-CTX, Cathe K and OPG levels in elderly patients with OPF for refracture. Results The level of serum β-CTX and Cathe K in the refracture group were higher than those in the non-refracture group, while the bone mineral density T value and the level of serum OPG were lower than those in the non-refracture group (P<0.05). Logistic regression analysis showed that the degree of fracture, bone mineral density T value, β-CTX, Cathe K, OPG are all risk factors that affect the recurrence of fractures in elderly OPF patients (P<0.05). ROC analysis showed that the sensitivity, specificity, and AUC of serum β-CTX, Cathe K, OPG combined to predict postoperative recurrence of fractures in elderly OPF patients were 87.50%, 85.23%, and 0.859, respectively, which were higher than β-CTX, Cathe K, OPG separately forecasts. Conclusion Serum β-CTX, Cathe K and OPG levels are higher in elderly patients with postoperative OPF fractures, which are risk factors for postoperative OPF fractures in the elderly, and have higher clinical value in the evaluation of postoperative OPF fractures in the elderly.

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