Clinical Study Of CTX And P1NP In Elderly Patients With OVCF

Objective:Osteoporosis is a common orthopaedic disease.Bone transition markers have received widespread attention in the clinical evaluation of osteoporosis treatment in the past decade.Combining changes in bone metabolic markers in patients’ serum can be used as important indicators to predict patients with vertebral fragility fractures.However,the analysis of BTM in serum remains a challenge for further clinical trials.This subject studies the C-terminal peptide of type 1 collagen,N-termial propeptide of type I procollagen,And in-depth discussion of its application in actual clinical practice,eventually discovered abnormal bone metabolism in patients at an early stage,which played a guiding role in preventing vertebral fragility fractures in osteoporotic patients.Methods:The inclusion and exclusion criteria were formulated as follows,Inclusion criteria:(1).Age>60 years old;(2).No anti-osteoporosis treatment or discontinuation of antibiotics and hormones for more than 72 hours;(3).Osteoporosis diagnosed by bone mineral density measurement;(4).There was no history of immune chemoradiotherapy within 1 week before consultation;(5).Within 5 days from injury to treatment;(6).Patient informed consent,refer to the research of this subject voluntarily,and have good compliance.Exclusion criteria:(1).Patients with liver,kidney,heart and other serious diseases and blood diseases;(2).The patient currently has bone tuberculosis,spine and related metastatic malignant tumors that affect bone metabolism;(3).Have been treated for bone loss or osteoporosis;(4).Smoking history;(5).More than 7d from injury to treatment;(6).Poor adherence to complete clinical data collectors.Fifty cases of elderly OP with vertebral compression fractures who were hospitalized in our hospital from February 2019 to March 2020 were included as the experimental group,and 50 cases of elderly OP without vertebral compression fractures were selected as the control group.All patients were fasted for at least 8 hours.The upper arm venous blood was taken on the fasting day after admission and sent to the laboratory medical staff for examination.Relevant medical examiners separated the serum of the patients.After the separation,the serum samples of the patients were immediately frozen in the refrigerator.After thawing,the medical examiners used Roche chemical immunoassay analyzer and supporting reagents to determine the serum CTX and P1NP levels of the patients.And the prognosis of 50 elderly patients with OVCF was followed up one month later,and the serum CTX and P1NP levels were reviewed.The changes of serum CTX and PINP levels in the good prognosis group and the poor prognosis group were analyzed and compared.Finally,SPSS 22.0 statistical software was used to process the data.For the comparison of count data,it was expressed as(%),and the χ2 test was used.For the comparison of measurement data,it was expressed as(mean ±standard deviation),and the t test was used.One-way ANOVA was used to compare the elderly The prognostic influencing factors of OVCF patients were analyzed by using binary logistic regression to analyze the correlation between CTX,P1NP and elderly OVCF,and the relationship between dynamic monitoring of CTX,P1NP and elderly OVCF was analyzed.P<0.05 was considered statistically significant.Results:1.There was no significant difference in the T-value(P=0.442 in lumbar T-value and P=0.788 in hip T-value),weight(P=0.1),height(P=0.3),body mass index(P=0.36),age(P=5.87)and gender(P=0.84)between the two groups of patients(P>0.05),and there was comparable.2.Comparison of serum CTX and P1NP levels between the two groups of patients:The levels of P1NP and CTX in the experimental group were significantly higher than those in the control group,with a significant difference(t=4.32%6.668,P<0.05).3.ROC curve results of the experimental group and control group showed:In older OP patients complicated with vertebral compression fractures prediction,its accuracy,sensitivity,specific degrees,with P1NP>39 ng/ml for critical value were 82.00%,80.00%,84.00%,and CTX>445 pg/ml for critical value were 81.00%,80.00%,82.00%,and P1NP,CTX both joint,specific degree of accuracy and sensitivity of 94.00%,93.00%,95.00%,data shows that both far below the joint when alone,with a significant difference(P<0.05).4.Logistic regression analysis showed that CTX(P=0.001)and P1NP(P=0.009)were significantly related to OVCF in the elderly,and the difference was statistically significant(P<0.05).And the univariate analysis of variance was used to analyze the prognosis of elderly OVCF patients with CTX(P=0.005),P1NP(P=0.006),the difference was statistically significant(P<0.05).In elderly OVCF patients,as the age increased,CTX in serum showed a positive linear correlation(r=0.730,P=0.000),and serum P1NP levels also had a positive correlation with age(r=0.968,P=0.000).There is also a positive correlation between CTX and P1NP levels(r=0.717,P=0.000).Conclusion:1.Changes in serum CTX and P1NP levels in elderly OVCF patients are significantly higher than those in elderly OP patients;2.Serum CTX and P1NP levels predict the accuracy,specificity,and sensitivity of elderly OVCF patients,and the combination of the two is better than the two alone;3.The changes of serum CTX and P1NP levels have a significant correlation with the clinical prognosis of patients after 1 month.