创伤性骨折患者血清miR-374a-5p、BMP2水平与凝血功能指标及术后深静脉血栓形成的关系  

Relationship between serum miR-374a-5p and BMP2 levels with coagulation function indicators and postoperative deep vein thrombosis in patients with traumatic fractures

作　　者：刘晖 范小波[1] 庞超见 安彪 王永彬 LIU Hui;FAN Xiaobo;PANG Chaojian;AN Biao;WANG Yongbin(First Department of Trauma and Orthopedics,Handan Municipal First Hospital,Handan,Hebei 056002,China)

机构地区：[1]河北省邯郸市第一医院创伤骨一科,河北邯郸056002

出　　处：《检验医学与临床》2024年第19期2854-2859,共6页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究课题计划项目(20231929)。

摘　　要：目的探讨创伤性骨折(TF)患者血清微小RNA-374a-5p(miR-374a-5p)、骨形态发生蛋白2(BMP2)水平与凝血功能指标及术后深静脉血栓(DVT)形成的关系。方法选择2023年1-12月在该院诊治的204例TF患者,根据术后是否发生DVT将患者分为非DVT组和DVT组。采用酶联免疫吸附试验(ELISA)检测血清BMP2水平,采用实时荧光定量PCR(qRT-PCR)检测血清miR-374a-5p水平,采用全自动凝血仪及配套试剂检测抗凝血酶Ⅲ(ATⅢ)、纤维蛋白原(Fib)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、D-二聚体(D-D)。通过多因素Logistic回归分析TF患者术后发生DVT的影响因素;在StarBase网站上分析miR-374a-5p与BMP2的关系;采用Pearson相关分析miR-374a-5p与BMP2水平的相关性及二者与凝血功能指标的相关性;采用受试者工作特征(ROC)曲线分析miR-374a-5p与BMP2水平对TF患者术后发生DVT的预测价值,比较曲线下面积(AUC)的差异。结果DVT组重度骨折的比例及miR-374a-5p、D-D、Fib水平均高于非DVT组(P<0.05),BMP2、ATⅢ水平低于非DVT组(P<0.05)。miR-374a-5p水平与ATⅢ水平呈负相关(r=-0.414,P<0.05),与D-D、Fib水平均呈正相关(r=0.424、0.427,P<0.05)。BMP2水平与ATⅢ水平呈正相关(r=0.423,P<0.05),与D-D、Fib水平均呈负相关(r=-0.416、-0.441,P<0.05)。miR-374a-5p、D-D水平升高是TF患者术后发生DVT的独立危险因素(P<0.05),BMP2、ATⅢ水平升高是TF患者术后发生DVT的独立保护因素(P<0.05)。miR-374a-5p、BMP2二者之间存在结合位点。DVT组血清miR-374a-5p水平与BMP2水平呈负相关(r=-0.449,P<0.001)。血清miR-374a-5p、BMP2单项及联合检测预测TF患者术后发生DVT的AUC分别为0.830(95%CI:0.771~0.879)、0.805(95%CI:0.744~0.857)、0.943(95%CI:0.902~0.971),2项联合检测预测的AUC大于miR-374a-5p、BMP2单项检测预测的AUC(Z=4.511、5.039,均P<0.001)。结论TF术后发生DVT的患者中血清miR-374a-5p、BMP2水平异常,2项指标之间存在结合位�Objective To explore the relationship between serum microRNA-374a-5p(miR-374a-5p)and bone morphogenetic protein 2(BMP2)levels with the coagulation function indicators and postoperative deep vein thrombosis(DVT)in the patients with traumatic fracture(TF).Methods A total of 204 patients with TF diagnosed and treated in this hospital from January to December 2023 were selected and divide into the non-DVT group and DVT group according to whether or not DVT occurring after surgery.The enzyme linked immunosorbent assay(ELISA)was used to detect the serum BMP2 levels,the real-time fluorescence quantitative PCR(qRT-PCR)was used to detect the serum miR-374a-5p levels,and the fully automated coagulation analyzer and matching reagents were used to detect antithrombinⅢ(ATⅢ),fibrinogen(Fib),prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and D-dimer(D-D).The influencing factors of postoperative DVT occurrence in TF patients were analyzed by the multivariate Logistic regression;the StarBase website was applied to analyze the relationship between miR-374a-5p and BMP2;the Pearson correlation was used to analyze the correlation between miR-374a-5p level and BMP2 level,as well as their correlation with the coagulation function indicators;the receiver operating characteristic(ROC)curve was used to analyze the predictive value of miR-374a-5p and BMP2 levels for postoperative DVT occurrence in TF patients,and the difference in the areas under the curves(AUC)was compared.Results The proportion of severe fractures,miR-374a-5p,D-D and Fib levels in the DVT group were higher than those in the non-DVT group(P<0.05),while the BMP2 and ATⅢlevels were lower than those in the non-DVT group(P<0.05).MiR-374a-5p was negatively correlated with ATⅢ(r=-0.414,P<0.05)and positively correlated with D-D and Fib(r=0.424,0.427,P<0.05).BMP2 was positively correlated with ATⅢ(r=0.423,P<0.05)and negatively correlated with D-D and Fib(r=-0.416,-0.441,P<0.05).The increase of miR-374a-5p and D-D levels was the indepen

关 键 词：创伤性骨折 微小RNA-374a-5p 骨形态发生蛋白2 凝血功能 深静脉血栓 

分 类 号：R446.11[医药卫生—诊断学] R683[医药卫生—临床医学]