维生素D3在成人骨折愈合中的作用

Amrit Kumar Singh, Arunabh Arora
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摘要

骨折在老年人群的发病和过早活动中起着重要的作用。由于骨折后的不活动对骨骼愈合和健康都有害,因此强烈建议骨折复发患者尽早或快速骨折愈合,以尽可能减少副作用,恢复正常。文献仍不清楚是否需要补充剂来促进骨折病例的骨愈合。因此,我们对骨折病例补充维生素D3的利弊进行了评价,并对骨折时和骨折愈合后的维生素D3进行了定量分析。共对200例患者进行临床、生化(血清碱性磷酸酶、血清维生素D3、血清甲状旁腺激素)和放射学评估。对所有符合纳入标准的患者进行随访,并在骨折后1天内和骨科干预后6个月间隔测量维生素D3水平。通过Warden等人的5分放射评分系统监测结果。大多数患者属于维生素不足组,即53%的患者在骨折时被发现维生素不足。33%的患者发现维生素D缺乏,14%的患者发现维生素D不足。没有发现病人处于中毒状态。根据沃顿的得分。在美国,50%的患者为3级,15%为4级,33%为2级,只有2%为1级。关于普通人群中维生素D缺乏或不足的普遍程度,这项研究显示,在一组200名患者中,维生素D不足的患者比例惊人,这表明需要关注维生素D状况,不仅是与骨骼有关的问题,还有与维生素D缺乏有关的其他问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Vitamin D3 in fracture union in adults
Fractures play an important role in morbidity and often premature mobility among the elderly population. Because inactivity as a result of a fracture is harmful both to bone healing and health, it appears early or rapid fracture healing would be highly recommendable for returning fracture patients to come back to normal as soon as possible with minimal side effects. The literature remains unclear regarding supplementation required for promoting bone healing in fracture cases. Hereby we evaluated the advantages and disadvantages of vitamin D3 supplementation in fracture cases along with the quantitative analysis of vitamin D3 at the time of fracture and after fracture union.: A total of 200 patients were assessed clinically, biochemically (serum alkaline phosphatase, serum vitamin D3, and serum parathormone), and radiologically. All patients who satisfy inclusion criteria are followed up and vitamin D3 levels were measured up within 1 day of fracture and at the interval of 6 months after the orthopaedic intervention. The outcomes were monitored by the 5 points radiographic scoring system by Warden et al. With the majority of patients falling under the vitamin insufficiency group i.e. 53% of all patients were found to be vitamin insufficient at the time of fracture. 33% of patients found to be vitamin D deficient while 14% found to be insufficient stage. No patient was found to be in a toxicity state. According to Warden’s scoring., 50% of patients were in grade 3, 15% in grade 4, 33% in grade 2, and only 2% in grade 1. Regarding the prevalence of vitamin D deficiency or insufficiency in the general population, this study shows an alarming rate of vitamin D insufficient patients in a group of 200 patients, which indicates the need for attention towards vitamin D status not only for bone-related issues but for other issues related to vitamin D deficiency.
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