骨折延迟愈合及骨不连与阻塞性睡眠呼吸暂停的相关性

背景：阻塞性睡眠呼吸暂停能影响成骨和/或破骨细胞及骨愈合相关调节蛋白,使骨折患者不易愈合或加重不愈合的程度。目的：观察阻塞性睡眠呼吸暂停与骨不连的相关性。方法：随机选取338例骨折的患者,其中骨愈合患者228例,骨不连110例,经便携式睡眠仪筛查出合并阻塞性睡眠呼吸暂停的骨不连患者11例,分析监测数据与临床资料的相关性。结果与结论：与骨愈合患者相比,骨不连患者阻塞性睡眠呼吸暂停患病率较高(P < 0.05),比值比(OR)=2.422,95%CI=0.996~5.891,合并阻塞性睡眠呼吸暂停的骨不连患者愈合时间与最低血氧饱和度、平均血氧饱和度呈负相关(r分别为0.40和0.38,P < 0.05),骨痂X射线评分与最低血氧饱和度、平均血氧饱和度呈正相关(r分别为0.34和0.47,P < 0.05)。提示阻塞性睡眠呼吸暂停可能是骨不连新的危险因素之一。

Delayed union and nonunion associated with obstructive sleep apnea

BACKGROUND:Obstructive sleep apnea (OSA) can affect the expression of regulatory proteins associated with bone and/or osteoclasts and bone healing, so the factures are difficult to heal and even aggravated. OBJECTIVE:To observe the association of OSA and nonunion.METHODS:Randomly selected in our hospital from June 2005 to June 2010 were 338 cases of fractures, of which 228 were patients with bone healing and 110 were patients with nonunion (11 cases combined with OSA confirmed by a portable sleep screening instrument). Monitoring data and relevant clinical data were analyzed. RESULTS AND CONCLUSION:Compared to patients with bone healing, OSA prevalence was higher in nonunion patients (P < 0.05), odds ratio(OR)=2.422, 95% confidence index (CI)=0.996-5.891; in the nonunion with OSA group, the healing time was correlated negatively with minimum oxygen saturation during the night (LSaO₂) and average oxygen saturation (MSaO2) (r=0.40, 0.38, P < 0.05), and the X-callus score was correlated positively with LSaO₂ and MSaO2 (r=0.34, 0.47, P < 0.05).OSA may be the new risk factors of nonunion.