血清Cx43 miR-125a-5p对四肢骨折延迟愈合临床诊断价值  

The clinical diagnostic value of serum Cx43 and miR-125a-5p for delayed union of extremity fractures

作　　者：郭月超[1] 安文 张玉舰[1] GUO Yuechao;AN Wen;ZHANG Yujian(Department of Orthopedics,Qinhuangdao First Hospital,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院骨一科,河北秦皇岛066000

出　　处：《安徽医学》2023年第3期273-278,共6页Anhui Medical Journal

基　　金：秦皇岛市科学技术研究与发展计划项目(编号:202101A079)。

摘　　要：目的 探讨微小RNA-125a-5p(miR-125a-5p)、细胞间隙连接蛋白43(Cx43)在四肢骨折患者血清中的表达水平及与骨折延迟愈合的关系。方法 选取2018年1月至2021年12月秦皇岛市第一医院收治的188例四肢骨折患者为研究对象,其中骨折延迟愈合患者30例作为延迟组,正常愈合患者158例为对照组。收集两组一般资料,采用实时荧光定量PCR(qRT-PCR)法测定两组对象血清miR-125a-5p、Cx43水平;利用受试者工作特征(ROC)曲线评价Cx43、miR-125a-5p水平对四肢骨折延迟愈合的预测价值;logistic回归分析影响四肢骨折延迟愈合发生的危险因素。结果 本研究中188例四肢骨折患者共有30例发生延迟愈合,发生率为15.96%;术后6周、术后12周时,延迟组血清Cx43表达水平低于对照组,miR-125a-5p水平高于对照组(P<0.05);多因素logistic回归分析结果显示,Cx43(OR=0.127,95%CI:0.021~0.775)、miR-125a-5p(OR=3.056,95%CI:1.092~8.552)、年龄(OR=1.142,95%CI:1.008~1.294)、吸烟(OR=1.537,95%CI:1.115~2.117)、骨折类型(OR=1.671,95%CI:1.084~2.577)、合并糖尿病(OR=2.024,95%CI:1.074~3.812)、合并骨质疏松(OR=1.525,95%CI:1.128~2.062)是影响四肢骨折延迟愈合发生的因素;ROC曲线结果显示,术后6周和术后12周血清Cx43、miR-125a-5p水平联合预测四肢骨折患者延迟愈合的曲线下面积(AUC)分别为0.944、0.964,均高于单一指标检测。结论 骨折延迟愈合患者血清中Cx43表达下调,miR-125a-5p表达上调,二者均是骨折延迟愈合的危险因素,联合检测二者表达水平对骨折延迟愈合有较高的预测价值。Objective To investigate the expression of microRNA-125a-5p and connexins 43(Cx43) in serum of patients with extremity fractures and their relationship with delayed fracture union.Methods A total of 188 patients with extremity fractures admitted to Qinhuangdao First Hospital from January 2018 to December 2021 were taken as the research objects. Among them 30 patients with delayed fracture union were regarded as the delayed group, and 158 patients with normal union were regarded as the control group. The general information was collected.Real-time fluorescence quantitative PCR(qRT-PCR) was performed to determine the levels of serum miR-125a-5p and Cx43.Receiver operating characteristic(ROC) curve was used to evaluate the predictive value of Cx43 and miR-125a-5p levels on delayed union of extremity fractures.Logistic regression analysis was performed to analyze the risk factors for delayed union of extremity fractures.Results Among the 188 extremity fracture patients in this study, delayed union occurred in 30 cases, andthe incidence rate was 15.96%;6 weeks and 12 weeks after operation, the expression levels of serum Cx43 in the delayed group were lower than those in the control group, and the level of miR-125a-5p was higher than that in the control group(P<0.05).Multivariate logistic regression analysis showed that Cx43(OR=0.127,95%CI:0.021~0.775),miR-125a-5p(OR=3.056,95%CI:1.092~8.552), age(OR=1.142,95%CI:1.008~1.294), smoking(OR=1.537,95%CI:1.115~2.117), fracture type(OR=1.671,95%CI:1.084~2.577), diabetes mellitus(OR=2.024,95%CI:1.074~3.812), and osteoporosis(OR=1.525,95%CI:1.128~ 2.062) were the factors that affected the delayed union of extremity fractures. ROC curve results showed that the area under the curve(AUC) of serum Cx43 combined with miR-125a-5p levels to predict delayed union in patients with extremity fractures 6 and 12 weeks after surgery was 0.944 and 0.964, respectively, which was higher than that detected by a single index.Conclusions The expression of Cx43 in serum of patients with delayed fra

关 键 词：四肢骨折 细胞间隙连接蛋白43 微小RNA-125a-5p 延迟愈合 

分 类 号：R683.4[医药卫生—骨科学]