脑外伤合并骨折病人血清中碱性成纤维细胞生长因子的研究

目的研究脑外伤合并骨折病人血清中碱性成纤维细胞生长因子（bFGF）与骨折愈合时间的关系。方法选择年龄18～55岁平时身体健康的病人,将病人分为4组,脑外伤合并骨折组（TBI＋F）20例;单纯脑外伤组（TBI）20例,与TBI＋F组脑外伤基本相同：昏迷程度,CT损伤程度;F组,单纯骨折组（F组）,与TBI＋F组病人骨折部位与类型基本相同均为四肢长管状骨骨折,TBI＋F组病人分别与TBI,F组病人配对,同时选择健康查体正常人为N组对照,采用酶联免疫吸附法（ELISA）进行血清中bFGF的测定,并进行统计学分析。同时将TBI＋F组与F组病人骨痂出现时间（X线）进行统计学分析。结果4组中TBI＋F组血清中bFGF含量高于TBI组、F组和N组（P〈0.01）,TBI组F组血清中bFGF含量高于N组（P〈0.05）,TBI组和F组血清中bFGF在统计学上无显著性差异。TBI＋F组骨折愈合时间较F组加快,形成骨病的量多（P〈0.01）。结论FBI＋F组与F组和FBI组病人血清中bFGF含量较正常人高,而FBI＋F组血清中bFGF高于F组和FBI组,在FBI＋F组骨折愈合时间较F组快,因此血清中bFGF同骨痂形成存在剂量依从性,即血清中bFGF增高可加快骨痂形成。

Study on serum level of bFGF in patients with traumatic brain injury and fracture.

Objective To study the relationship between serum level of bFGF and healing time of fracture. Methods Patients with age of 18 - 55 years were divided into three groups ： 20 cases in TBI ＋ F （ traumatic brain injury and fracture） group, 20 cases in TBI （ traumatic brain injury） group and 20 cases in F （fracture） group, and 10 healthy persons were allocated in N （normal） group for control. The degree of brain injury in patients of TBI group was essentially similar with that of patients in TBI ＋ F group and F group, and the fracture type and position were also similar with those in TBI ＋ F group. Comparison between patients in TBI ＋ F group with those in F group and TBI group were separately carried out. At the same time, healthy controls （ N group） were also examined and compared with them. Serum level of bFGF was examined by ELISA. Their findings were statistically analyzed. The scab appearing time （ by x - ray examination） in patients of TBI ＋ F group and F group was also statistically analyzed. Results The serum level of bFGF in patients of TBI ＋ F group was much higher than that of patients in other groups （ P 〈 0. 01 ）, and serum levels of bGFG in patients of TBI group and F group were higher than that of controls in N group （ P 〈0.01 ）. There was no sta- tistical difference in serum level of bFGF between patients of TBI group and F group. The scab forming time was accelerated in patients of TBI ＋ F group （ P 〈 0.01 ）. Conclusion The serum levels of bFGF in cases of TBI ＋ F group, TBI group and F group were higher than that of healthy controls in N group. However serum level in patients of TBI ＋ F group was much higher than that of patients in TBI or F group. The healing of fracture in patients of TBI ＋ F group was faster than that of patients in F group. So the concentration of serum level of bFGF is closely related with scab appearing time. In other word, the higher serum level of bFGF can speed up the appearance of scab, hence serum level of bFGF can be applied for estimation of the degree of fracture healing in these patients.