血清PTEN、BMP-9水平与胫骨平台骨折术后愈合延迟的关系  

Relationships between serum PTEN and BMP-9 levels and postoperative delayed healing of tibial plateau fractures

作　　者：任伟民 李佳 舒文[1] 陈凯[1] 黄劲东[1] REN Weimin;LI Jia;SHU Wen;CHEN Kai;HUANG Jindong(Trauma Orthopedics and Burn Department,Liuzhou People's Hospital,Liuzhou 545000,China)

机构地区：[1]柳州市人民医院创伤骨科烧伤科,广西柳州545000

出　　处：《山东医药》2022年第22期19-23,共5页Shandong Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20210042)。

摘　　要：目的探讨血清第10号染色体缺失性磷酸酶-张力蛋白同源物基因(PTEN)、骨形成蛋白-9(BMP-9)水平与胫骨平台骨折术后愈合延迟的关系。方法选择129例行内固定手术治疗的胫骨平台骨折患者,根据术后是否发生愈合延迟分为延迟愈合组(19例)和正常愈合组(110例)。分别于术前、术后1、2、4周采用实时荧光定量聚合酶链反应检测血清PTENmRNA表达,采用酶联免疫吸附试验检测血清BMP-9水平。收集临床资料,多因素Logistic回归分析影响胫骨平台骨折术后愈合延迟的因素,绘制受试者工作特征曲线,分析PTENmRNA、BMP-9预测胫骨平台骨折术后愈合延迟的价值。结果两组手术前后血清PTENmRNA、BMP-9水平呈逐渐增高趋势(P均<0.05),延迟愈合组术后1、2、4周血清PTENmRNA、BMP-9均低于正常愈合组(P均<0.05)。多因素Logistic回归分析结果显示,骨质疏松、术后4周PTENmRNA、术后4周BMP-9与胫骨平台骨折患者术后延迟愈合有关(P均<0.05)。术后4周PTENmRNA、BMP-9预测胫骨平台骨折术后愈合延迟的曲线下面积为0.752、0.726,联合预测的曲线下面积为0.923,高于单独指标预测(Z分别为3.105、3.273,P均<0.05)。结论胫骨平台骨折术后延迟愈合患者血清PTEN mRNA、BMP-9水平均降低,术后4周PTENmRNA、BMP-9可作为预测骨折延迟愈合的指标。Objective To investigate the relationships between serum levels of phosphatase and tensin homology de⁃leted on chromosome ten(PTEN)and bone morphogenetic protein 9(BMP-9)and postoperative delayed healing of tibial plateau fractures.Methods Totally 129 patients with tibial plateau fractures treated with internal fixation were selected and divided into the delayed healing group(19 cases)and normal healing group(110 cases)according to whether postop⁃erative healing delay occurred.Serum PTEN mRNA expression was detected by real-time fluorescence quantitative poly⁃merase chain reaction,and serum BMP-9 level was detected by enzyme-linked immunosorbent assay before surgery,1,2,and 4 weeks after surgery,respectively.The clinical data were collected,and the factors influencing postoperative healing delay of tibial plateau fractures were analyzed by multivariate Logistic regression analysis.Receiver operating characteris⁃tic(ROC)curve was drawn,and the value of PTEN mRNA and BMP-9 in predicting postoperative healing delay of tibial plateau fractures was analyzed.Results The levels of serum PTEN mRNA and BMP-9 in the two groups gradually in⁃creased before and after operation(both P<0.05).The levels of serum PTEN mRNA and BMP-9 in the delayed healing group were lower than those in the normal healing group at 1,2 and 4 weeks after operation(all P<0.05).Multivariate Lo⁃gistic regression analysis showed that osteoporosis,PTEN mRNA at 4 weeks after surgery,BMP-9 at 4 weeks after surgery were related to delayed healing of tibial plateau fracture patients(all P<0.05).The area under the curve of PTEN mRNA and BMP-9 at 4 weeks after surgery in predicting delayed healing of tibial plateau fractures was 0.752 and 0.726,and the area under the curve of them combined was 0.923,which was higher than that of either index alone(Z=3.105 and 3.273,both P<0.05).Conclusion The levels of PTEN mRNA and BNM-9 in patients with delayed healing of tibial plateau fracture after surgery decrease,and PTEN mRNA and BNM-9 at 4 weeks after oper

关 键 词：胫骨平台骨折 愈合延迟 第10号染色体缺失性磷酸酶-张力蛋白同源物基因 骨形成蛋白-9 

分 类 号：R274.1[医药卫生—中医骨伤科学]