IGF⁃1、TNF⁃α、NF⁃κB p65亚基预测胫骨平台骨折术后愈合延迟的价值  

Value of serum IGF⁃1,TNF⁃αand NF⁃κB p65 subunit levels in predicting delayed healing of tibial plateau fracture surgery

作　　者：徐向阳 孙军平 李云朋 王鹏 朱琳[4] 刘汝银 XU Xiangyang;SUN Junping;LI Yunpeng;WANG Peng;ZHU Lin;LIU Ruyin(Department of Orthopaedics,Henan Provincial Hospital of Traditional Chinese Medicine(The Second Affiliated Hospital Of Henan University of TCM),Zhengzhou,Henan,China,450000;Department of Orthopaedics,Qingyang Second People's Hospital,Qingyang,Gansu,China,745000;Department of Orthopaedics,Zhengzhou Renji Orthopedic Hospital,Zhengzhou,Henan,China,450000;Department of Orthopaedics,The Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou,Henan,China,450000)

机构地区：[1]河南省中医院(河南中医药大学第二附属医院)骨科,河南郑州450000 [2]庆阳市第二人民医院骨科,甘肃庆阳745000 [3]郑州市仁济骨科医院骨科,河南郑州450000 [4]河南中医药大学第三附属医院骨科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2021年第8期1333-1336,1340,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省科技攻关项目(201902311125)。

摘　　要：目的探究血清胰岛素样生长因子⁃1(IGF⁃1)、肿瘤坏死因子⁃α(TNF⁃α)和核转录因子κB亚基p65(NF⁃κB p65)在胫骨平台骨折术后愈合延迟患者中的表达水平,分析其对骨折愈合延迟的预测价值。方法选取2019年8月至2020年8月本院骨科收治的178例胫骨平台骨折患者,根据患者术后骨折愈合情况分为延迟愈合组(n=34)和正常愈合组(n=144),比较两组患者不同时间点血清IGF⁃1、TNF⁃α和NF⁃κB p65亚基的表达水平,采用受试者工作特征曲线(ROC)评估以上指标预测患者愈合延迟的价值。结果术后4、8和12周,延迟愈合组患者的血清IGF⁃1水平明显低于正常愈合组,差异均有统计学意义(P<0.05)。术后1、4、8和12周,延迟愈合组患者的TNF⁃α、NF⁃κB p65亚基表达水平明显高于正常愈合组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,IGF⁃1、TNF⁃α和NF⁃κB p65三者联合检测胫骨平台骨折术后愈合延迟的敏感度和特异度分别为92.30%、76.90%,AUC值为0.863,明显高于单个指标检测(P<0.05)。结论血清IGF⁃1、TNF⁃α和NF⁃κB p65亚基的表达水平与胫骨平台骨折术后愈合延迟密切相关,可作为预测胫骨平台骨折术后愈合延迟的良好指标,联合检测可提高预测准确性。Objective To explore the expression levels of serum insulin⁃like growth factor⁃1(IGF⁃1),tumor necrosis factor⁃α(TNF⁃α)and nuclear transcription factorκB subunit p65(NF⁃κB p65)in patients with delayed healing of tibial plateau fracture surgery,and analyze their predictive value for delayed fracture healing.Methods A total of 178 patients with tibial plateau fractures admitted to orthopedics department of the hospital were enrolled in this study from August 2019 to August 2020.They were divided into the delayed healing group(n=34)and the normal healing group(n=144)according to postoperative fracture healing situa⁃tion.The expression levels of serum IGF⁃1,TNF⁃αand NF⁃κB p65 subunit at different time points were com⁃pared between the two groups.The value of the above indicators in predicting delayed healing was evaluated by the receiver operating characteristic(ROC)curves.Results At 1,4,8 and 12 weeks after surgery,the expression levels of TNF⁃αand NF⁃κB p65 subunit in the delayed healing group were significantly higher than those in the normal healing group,with a statistically significant difference(P<0.05).At 4,8 and 12 weeks after surgery,level of serum IGF⁃1 in the delayed healing group was significantly lower than that in the normal healing group,with a statistically significant difference(P<0.05).The results of ROC curves analysis showed that the sensitivity and specificity of IGF⁃1 combined with TNF⁃αand NF⁃κB p65 subunit for predicting de⁃layed healing of tibial plateau fracture surgery were 92.30%and 76.90%,respectively.Their AUC was 0.863,significantly higher than that of single indicator(P<0.05).Conclusion The expression levels of serum IGF⁃1,TNF⁃αand NF⁃κB p65 subunit are closely related to the postoperative healing delay of tibial plateau fractures.They can be used as good indicators to predict the postoperative healing delay of tibial plateau fractures.Com⁃bined detection can improve the accuracy of prediction.

关 键 词：胫骨平台骨折 愈合延迟 胰岛素样生长因子⁃1 肿瘤坏死因子⁃α 核转录因子κB亚基p65 

分 类 号：R687.3[医药卫生—骨科学]