老年股骨粗隆间骨折患者血清SOX4和BMP2水平表达及其临床意义  

Expression and Clinical Significance of Serum SOX4 and BMP2 inElderly Patients with femoral Intertrochanteric Fracture

作　　者：张伟 张斌[2] ZHANG Wei;ZHANG Bin(Lower Limb Arthrology Department,Jiangyou People’s Hospital in Sichuan Province,Sichuan Jiangyou 621700,China;Department of Orthopedics,Jiangyou People’s Hospital in Sichuan Province,Sichuan Jiangyou 621700,China)

机构地区：[1]四川省江油市人民医院下肢关节科,四川江油621700 [2]四川省江油市人民医院骨科,四川江油621700

出　　处：《现代检验医学杂志》2023年第6期108-113,共6页Journal of Modern Laboratory Medicine

基　　金：四川省医学会骨科疾病专项科研课题立项(编号:2020SAT28):县级三级医院下快速康复模式在股骨粗隆间骨折手术治疗的应用。

摘　　要：目的 探讨血清性别决定区Y框4(sex determining region Y-box 4,SOX4)和骨形态发生蛋白2(bone morphogenetic protein-2,BMP2)在老年股骨粗隆间骨折患者中的蛋白变化及临床意义。方法 收集江油市人民医院2018年1月~2020年1月住院治疗的80例老年股骨粗隆间骨折患者,根据术后一年的髋关节功能将患者分为优良组(n=62)和欠佳组(n=18),对比两组间患者术前和术后24h血清SOX4和BMP2水平变化。比较两组一般资料;Logistic回归分析老年股骨粗隆间骨折患者预后的影响因素;受试者工作特征(receiver operating characteristic,ROC)曲线分析血清SOX4和BMP2水平对老年股骨粗隆间骨折患者预后的评估价值。结果 术前和术后24h欠佳组血清SOX4表达水平(332.28±58.84pg/ml,76.86±7.79pg/ml)均高于优良组(238.32±43.98pg/ml,65.26±6.56pg/ml),差异有统计学意义(t=7.373,6.328,均P=0.000);术后24h欠佳组血清BMP2表达水平(143.27±35.56mg/L)低于优良组(237.58±46.98mg/L),差异有统计学意义(t=7.873,P=0.000)。优良组与欠佳组年龄、手术时间、术后引流量、Harris髋关节功能评分,差异均有统计学意义(t=3.787,3.319,4.795,7.815,均P<0.05)。多因素Logistic回归分析显示,术前SOX4水平[OR(95%CI)=3.548(1.773~7.101)]、术后24h SOX4水平[OR(95%CI)=1.982(1.340~2.910)]、手术时间[OR(95%CI)=2.343(1.274~4.310)]、术后引流量[OR(95%CI)=1.753(1.151~2.685)]为老年股骨粗隆间骨折患者预后不良的危险因素(均P <0.05);术后24h BMP2水平[OR(95%CI)=0.683(0.558~0.836)]、Harris髋关节功能评分[OR(95%CI)=0.102(0.047~0.221)]为保护因素(均P <0.05)。术前SOX4,术后24h SOX4和术后24h BMP2水平评估老年股骨粗隆间骨折患者髋关节功能的曲线下面积(area under curve,AUC)分别为0.950,0.912和0.934。结论 血清SOX4水平和BMP2水平均为老年股骨粗隆间骨折患者预后的影响因素,二者可较好地评估老年股骨粗隆间骨折患者的预后。Objective To investigate the changes of serum sex determining region Y-box 4(SOX4)and bone morphogenetic protein 2(BMP2)in elderly patients with femoral intertrochanteric fracture and their clinical significance.Methods Collected 80 elderly patients with intertrochanteric fractures of the femur who were hospitalized at Jiangyou People’s Hospital from January 2018 to January 2020,and the changes of serum SOX4 and BMP2 levels before and 24 hours after operation were compared.The patients were divided into excellent group(n=62)and poor group(n=18)according to the hip joint function one year after operation.The general data of the two groups were compared,Logistic regression analysis was used to analyze the prognostic factors of elderly patients with femoral intertrochanteric fracture,and the receiver operating characteristic(ROC)curve was used to analyze the prognostic value of serum SOX4 and BMP2 levels in elderly patients with femoral intertrochanteric fracture.Results The expression level of serum SOX4 in poor group(332.28±58.84pg/ml,76.86±7.79pg/ml)was higher than that in excellent group before operation and at 24 hours after operation(238.32±43.98pg/ml,65.26±6.56pg/ml),and the differences were statistically significant(t=7.373,6.328,all P=0.000).At 24h after operation,the expression level of serum BMP2 in poor group(143.27±35.56mg/L)was lower than that in excellent group(237.58±46.98mg/L),and the difference was statistically significant(t=7.873,P=0.000).There were obvious differences between excellent group and poor group in age,operation time,postoperative drainage volume and Harris hip function score(t=3.787,3.319,4.795,7.815,all P<0.05).Multivariate Logistic regression analysis showed that preoperative SOX4 level[OR(95%CI)=3.548(1.773~7.101)],postoperative 24h SOX4 level[OR(95%CI)=1.982(1.340~2.910)],operation time[OR(95%CI)=2.343(1.274~4.310)]and postoperative drainage volume[OR(95%CI)=1.753(1.151~2.685)]were the risk factors for poor prognosis of elderly patients with femoral intertrochanteric f

关 键 词：性别决定区Y框4 骨形态发生蛋白2 老年股骨粗隆间骨折 

分 类 号：R683.42[医药卫生—骨科学] R392.11[医药卫生—外科学]