[1]池继敏a,张 静a,邹 明a,等.骨折患者初期血清钙磷浓度变化与骨折部位的相关性分析[J].现代检验医学杂志,2024,39(06):218-222.[doi:10.3969/j.issn.1671-7414.2024.06.038]
　CHI Jimina,ZHANG Jinga,ZOU Minga,et al.Analysis of the Correlation between Serum Calcium and Phosphorus Concentration Changes and Fracture Site in Early Fracture Patients[J].Journal of Modern Laboratory Medicine,2024,39(06):218-222.[doi:10.3969/j.issn.1671-7414.2024.06.038]
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骨折患者初期血清钙磷浓度变化与骨折部位的相关性分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年06期
页码:
218-222
栏目:
检验与临床
出版日期:
2024-11-15

文章信息/Info

Title:
Analysis of the Correlation between Serum Calcium and Phosphorus Concentration Changes and Fracture Site in Early Fracture Patients
文章编号:
1671-7414（2024）06-218-05
作者:
池继敏a; 张 静a; 邹 明a; 程松苗b; 李 敏c; 刘小莉a
（四川省骨科医院 a. 检验科；b. 膝关节运动损伤科；c. 风湿骨关节病科，成都 610041）
Author(s):
CHI Jimina;  ZHANG Jinga;  ZOU Minga;  CHENG Songmiaob;  LI Minc;  LIU Xiaolia
（a. Department of Clinical Laboratory；b. Department of Knee Joint Sports Injury；c. Department of Rheumatology and Osteoarthrology, Sichuan Province Orthopedic Hospital, Chengdu 610041, China）
关键词:
骨折; 血钙; 血磷; 钙磷乘积
分类号:
R683；R446.111
DOI:
10.3969/j.issn.1671-7414.2024.06.038
文献标志码:
A
摘要:
目的 探究骨折患者初期血钙、血磷、钙磷乘积水平变化并分析其与骨折部位的相关性。方法 选取2021 年1 月～ 2023 年11 月四川省骨科医院收治的骨折患者1 049 例作为研究对象，按骨折部位粗分为两组：上半身部位骨折（n=478）和下半身部位骨折（n=571）；细分十组：椎体骨折（n=108）、锁骨骨折（n=109）、上肢骨折（n=106）、手部骨折（n=104）、股骨颈骨折（n=103）、股骨粗隆间骨折（n=106）、髌骨骨折（n=101）、下肢骨折（n=103）、足部骨折（n=105）和其他骨折（n=104）。另选取同期健康体检人群110 例作为对照组。全部患者于急诊当日和入院后24 ～ 48h 两次抽取静脉血测定血钙、血磷，并计算钙磷乘积，比较三者水平变化并分析其与骨折部位的相关性。结果 与对照组比较，骨折患者急诊当日和入院后24 ～ 48h，血钙（2.27±0.12 mmol/L，2.19±0.12 mmol/L vs2.35±0.10mmol/L）、血磷（1.00±0.20mmol/L，1.08±0.19mmol/L vs 1.15±0.15mmol/L）、钙磷乘积（28.10±6.00mg/dl，29.30±5.85mg/dl vs 33.41±4.87mg/dl）均降低，差异具有统计学意义（t=6.804，12.501；7.475，3.722；8.964，7.115，均P ＜ 0.01）。上、下半身骨折相比，急诊当日血钙、血磷和钙磷乘积下半身骨折低于上半身骨折（t=4.129，5.931，6.660，均P ＜ 0.01）；入院后24 ～ 48h 则仅钙、钙磷乘积下半身骨折低于上半身骨折（t=6.432，1.990，均P ＜ 0.05），差异具有统计学意义。沿时间轴比较，入院后24 ～ 48h 与急诊当日相比，上、下半身骨折均表现出血钙降低而血磷升高（t=12.779，-5.730；16.919，-14.358），钙磷乘积则仅下半身骨折较急诊当日升高（t= -8.860），差异具有统计学意义（均P ＜ 0.01）。不同部位骨折患者入院后24 ～ 48h 与急诊当日相比，除椎体骨折外，其余九组血钙均降低（t=6.233 ～ 11.349）；除上肢骨折、手部骨折外，其余八组血磷升高（t=-7.770 ～ -3.327）；椎体骨折、股骨颈骨折、股骨粗隆间骨折、下肢骨折、足部骨折、其他骨折钙磷乘积升高（t=-5.819 ～ -2.927），差异具有统计学意义（均P ＜ 0.01）。结论 骨折患者急诊当日血钙、血磷和钙磷乘积均降低，24 ～ 48h 后多数患者血钙持续降低，血磷和钙磷乘积逐渐回升，其水平变化程度与骨折部位有关。
Abstract:
Objective To explore the changes in early serum calcium, serum phosphorus, and calcium-phosphorus product levels in patients with fractures and analyze their correlation with the fracture site. Methods 1 049 patients with fractures admitted to Sichuan Province Orthopedic Hospital from January 2021 to November 2023 were selected as the research subjects. According to the fracture location，they were roughly divided into two groups: upper body fracture(n=478) and lower body fracture(n=571). Carefully divided into ten groups: vertebral fracture(n=108), clavicle fracture(n=109), upper limb fracture(n=106), hand fracture(n=104), femoral neck fracture(n=103), femoral intertrochanteric fracture(n=106), patella fracture(n=101), lower limb fracture(n=103), foot fracture(n=105) and other fractures(n=104). Another 110 cases of healthy physical examination people during the same period were selected as the control group. Venous blood was drawn from all patients twice on the day of emergency within 24 to 48 hours after admission, serum calcium and serum phosphorus were measured, and the calciumphosphorus product was calculated. Compare the changes in the levels of the three and analyzed their correlation with the fracture site. Results Compared with the control group, the serum calcium(2.27±0.12 mmol/L，2.19±0.12 mmol/L vs 2.35±0.10mmol/L), serum phosphorus( 1.00±0.20mmol/L，1.08±0.19mmol/L vs 1.15±0.15mmol/L), and calcium-phosphorus product(28.10±6.00mg/dl，29.30±5.85mg/dl vs 33.41±4.87mg/dl) of fracture patients were all reduced on the day of emergency and 24 to 48 hours after admission, and the differences were statistically significant (t=6.804，12.501； 7.475，3.722；8.964，7.115，all P ＜ 0.01). Comparing upper and lower body fractures, serum calcium, serum phosphorus, and calcium-phosphorus product on the emergency day was lower in lower body fracture than in upper body fracture (t=4.129, 5.931, 6.660, all P ＜ 0.01), 24 to 48 hours after admission, only the serum calcium and calcium-phosphorus product were lower in lower body fracture than in upper body fracture (t=6.432, 1.990, all P ＜ 0.05) , and the differences were statistically significant，respectively. Comparing along the time axis, 24 to 48 hours after admission compared with the emergency day, both upper and lower body fractures showed a decrease in serum calcium and an increase in serum phosphorus（t=12.779，-5.730； 16.919，-14.358），calcium-phosphorus product only increased in lower body fracture（t=-8.860）, and the differences were statistically significant（all P ＜ 0.01)，respectively. Compared with the day of emergency, 24 to 48 hours after admission for patients with fractures in different parts, except for vertebral fracture, serum calcium in the other nine groups decreased (t= 6.233 ～ 11.349, all P ＜ 0.01)，except for upper limb fracture and hand fracture, the serum phosphorus in the other eight groups increased (t= -7.770 ～ -3.327, all P ＜ 0.01)，the calcium-phosphorus product of vertebral fracture, femoral neck fracture, femoral intertrochanteric fracture, lower limb fracture, foot fracture, and other fractures increased (t= -5.819 ～ -2.927, all P ＜ 0.01), and the differences were statistically significant，respectively. Conclusion The serum calcium, serum phosphorus, and calcium-phosphorus product of patients with fractures all decreased on the day of emergency. 24 to 48 hours later, the serum calcium of most patients continued to decrease while the serum phosphorus and calcium-phosphorus product gradually increased. The degree of change in their levels was related to the fracture site.

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备注/Memo

备注/Memo:
基金项目：成都市卫生健康委员会科研项目（编号：2022447）。
作者简介：池继敏（1979-），女，本科，副主任技师，研究方向：临床生化和骨代谢，E-mail:565092843@qq.com。
更新日期/Last Update: 2024-11-15