Study On The Change Of Bone Metabolism And Biomechanical Characteristics Of Thoracic Motion In Pectus Excavatum

Objective: To investigate the relationship between pectus excavatum and serum calcium, phosphorus, magnesium, zinc, alkaline Phosphatase, bone alkaline Phosphatase of patients with pectus excavatum. To study on the change of biomechanics of thoracic motion in pectus excavatum.Methods: From April 2006 to December 2007, 43 patients with pectus excavatum who visited in the First Affiliated Hospital of Kunming Medical Collage were divided into three groups by funnel index. 35 patients without thoracic disease were categorized as control group. To detect serum calcium, phosphorus, magnesium, zinc, alkaline Phosphatase of all members to make use of Olympus AU5400 automated clinical chemistry analyzer. And detecting bone alkaline Phosphatase by dry chemistry and colorimetry. The chests of all patients with pectus excavatum were scanned by Marconi MX8000 spiral CT. And to measure transverse thoracic diameter and anteroposterior diameter was to understand the change of Thoracic motion.Results: (1)The preoperative serum phosphorus, alkaline Phosphatase and bone alkaline Phosphatase in pectus excavatum group were significantly higher than that in control group (P<0.05) . The preoperative serum calcium, magnesium and zinc were no disparity in both groups (P>0.05) . (2)The preoperative serum phosphorus, alkaline Phosphatase and bone alkaline Phosphatase increased along with the anisotrophy degree in pectus excavatum (P<0.05) . The preoperative serum calcium, magnesium and zinc were no disparity among all groups (P>0.05). (3)The serum phosphorus, calcium, magnesium, zinc, alkaline Phosphatase and bone alkaline Phosphatase were no disparity between preoperative pectus excavatum and postoperative (P>0.05) . (4) The transverse thoracic diameters of all groups were no disparity (P>0.05) . The anteroposterior diameters of all groups were significantly disparity (P<0.05) ,and likewise the relative values between transverse thoracic diameter and anteroposterior diameter were significantly disparity (P <0.05) .(5)The change of transverse thoracic diameter at the end of deep expiration and deep inspiration in serious pectus excavatum was more conspicuous than that in other groups (P<0.05) . The changes of anteroposterior diameter were significantly disparity among all groups (P<0.05) .The relative values between the changed value of transverse thoracic diameter and anteroposterior diameter were significantly disparity (P<0.05) among all groups except between mild and midrange pectus excavatum (P>0.05) .Conclusions: (1)The preoperative serum alkaline Phosphatase and bone alkaline Phosphatase in pectus excavatum increased because the bone formation and growth of the sternum, rib and costal cartilage was disorder and faster than normal people. (2)The increase of serum phosphorus in pectus excavatum led to that the calcium-phosphorus product stepped up. Furthermore, the increase of the calcium-phosphorus product promoted bone formation and growth of the sternum, rib and costal cartilage. (3)The transversal thoracic motion of patients with pectus excavatum was not restricted, but the longitudinal thoracic motion was obviously restricted. The Biomechanics properties of sternum, rib and costal cartilage of patients with pectus excavatum surely stepped down.