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| Clinical Value of Combined Detection of Serum Lp-PLA2 and cTnT in Predicting Occurrence of Perioperative MACE in Elderly Patients with Hip Fractures |
| LIANG Li-zhuo, LU Bin |
| Department of Orthopaedics,Tangdu Hospital Affiliated to Air Force Medical University,Xi'an Shaanxi 710000 |
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Abstract 【Objective】To investigate the value of combined detection of serum lipoprotein-associated phospholipese A2 (Lp-PLA2) and cardiac troponin T (cTnT) in predicting the occurrence of MACE (Major adverse cardiovascular events) in elderly patients with hip fractures during perioperative period. 【Methods】A total of 1,267 elderly patients with hip fractures who underwent surgical treatment in our hospital between January 2015 and June 2021 were selected for prospective analysis. All patients underwent internal fixation or artificial hip replacement within 2 to 5 d after admission. There were 84 patients who developed MACE within 30 days after surgery were included in the MACE group,while 127 patients who were randomly (by using the random number table method) selected from no MACE patients were considered as the control group. The general data,preoperative examination results,perioperative indicators and levels of serum Lp-PLA2 and cTnT were collected and compared between the two groups. Receiver operating characteristic (ROC) curve was drawn and the area under the curve (AUC) was calculated to analyze the predictive value of serum Lp-PLA2 and cTnT levels in predicting perioperative MACE. 【Results】The average age,proportion of coronary heart disease and complication with other diseases in the MACE group were significantly higher than those in control group (P<0.05). The levels of serum Lp-PLA2 and cTnT at 1 d,3 d and 7 d after surgery in the two groups significantly increased if compared to those at 1 d before surgery (P<0.05). In addition,the levels of serum Lp-PLA2 and cTnT in the MACE group at 1 d,3 d and 7 d after surgery were higher than those in control group (P<0.05). ROC curve analysis results showed that the AUC values of serum Lp-PLA2,cTnT and the combination of both detections at 1 d after surgery in predicting perioperative MACE in elderly patients with hip fractures were 0.665,0.703 and 0.755,respectively; The AUC values of serum Lp-PLA2,cTnT and combination of the two at 3 d after surgery were 0.765,0.792 and 0.853,and their AUC values at 7 d after surgery were 0.825,0.852 and 0.932,respectively. 【Conclusion】The levels of serum Lp-PLA2 and cTnT in elderly patients with hip fractures are significantly increased after surgery. The combined detection of the two has a good reference value for predicting the occurrence of perioperative MACE.
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Received: 23 July 2022
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[1] ESEN E,DUR H.Evaluation of proximal femoral nail-antirotation and cemented,bipolar hemiarthroplasty with calcar replacement in treatment of intertrochanteric femoral fractures in terms of mortality and morbidity ratios[J].Eklem Hastalik Cerrahisi,2017,28(1):35-40.
[2] 王金强,骆洪涛,王晓伟,等.老年髋部骨折患者术后30 d内新发心脏不良事件的危险因素分析[J].中华创伤骨科杂志,2020,22(6):518-522.
[3] 梁海青,郭牧,张云强,等.脂蛋白相关磷脂酶A2预测老年急性冠状动脉综合征患者介入治疗后主要不良心血管事件[J].中华老年心脑血管病杂志,2020,22(11):39-42.
[4] 胡文兰,陈游洲,王继红,等.骨科手术患者围手术期肌钙蛋白升高的临床特点分析[J].中华内科杂志,2018,57(5):340.
[5] 米尔阿里木·木尔提扎,蔺海山,艾尼瓦尔江·达毛拉,等.磷脂酰肌醇激酶-3、蛋白激酶在绝经后髋部骨折患者骨骼肌组织中的表达及其临床意义[J].医学临床研究,2020,37(5):664-667.
[6] 刘四海,王飞,韩新祚,等.老年髋部骨折患者围术期特点及术后早期康复的疗效[J].中华老年医学杂志,2018,37(12):1337-1339.
[7] EKELOEF S,KOYUNCU S,HOLST-KNUDSEN J,et al.Cardiovascular events in patients undergoing hip fracture surgery treated with remote ischaemic preconditioning:1-year follow-up of a randomised clinical trial[J].Anaesthesia,2021,76(8):1042-1050.
[8] 杨波,杨晋才,臧传义,等.老年髋部骨折患者术后新发心脏不良事件的危险因素[J].中华老年多器官疾病杂志,2020,19(7):515.
[9] 高长虹,李震花,张涛.老年髋部骨折手术前后血清B型尿钠肽和心肌肌钙蛋白的变化[J].中国矫形外科杂志,2017,432(22):2042-2045.
[10] 喻茂文.血清Lp-PLA2、hs-CRP、D-二聚体水平与冠心病患者病情的相关性分析[J].医学临床研究,2021,38(3):349-351. |
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2022, Vol. 39 
