表皮生长因子、C1q/TNF相关蛋白3及骨代谢水平与上肢骨折愈合的相关性  

Correlation of epidermal growth factor,C1q/TNF related protein 3 and bone metabolism levels with upper limb fracture healing

作　　者：周运平 李刚[1] 姜可 成德亮 卢锡钦 张丽君 欧学海 ZHOU Yun-ping;LI Gang;JIANG Ke(Manual Clinic Center,Red Society Hospital Affiliated to Xi'an Jiaotong University,Xi'an Shaanxi 710000,China)

机构地区：[1]西安交通大学附属红会医院手外诊疗中心,陕西西安710000

出　　处：《临床和实验医学杂志》2024年第22期2404-2408,共5页Journal of Clinical and Experimental Medicine

基　　金：陕西省科技厅计划项目(编号:2019SF-06013)。

摘　　要：目的探究表皮生长因子(EGF)、C1q/TNF相关蛋白3(CTRP3)及骨代谢水平与上肢骨折愈合的相关性。方法前瞻性选取2019年6月至2023年11月西安交通大学附属红会医院收治的90例上肢骨折患者为研究对象,根据术后6个月骨折愈合情况分为正常愈合组(n=67)、延迟愈合组(n=23)。对比两组患者EGF、CTRP3及骨代谢相关指标[β-Ⅰ型胶原羧基端肽(β-CTx)、可溶性黏附分子CD44(sCD44)、成纤维细胞生长因子-2(FGF-2)]水平。采用多因素Logistic回归分析影响上肢骨折患者正常愈合的因素;采用受试者操作特征(ROC)曲线分析EGF、CTRP3、β-CTX、sCD44、FGF-2对上肢骨折正常愈合的预测价值。结果术后7 d,两组患者EGF、CTRP3水平均较术后1 d升高,且正常组患者EGF、CTRP3水平分别为(0.98±0.16)、(217.85±51.05)pg/mL,均高于延迟组[(0.87±0.12)、(144.62±41.95)pg/mL],差异均有统计学意义(P<0.05)。术后7 d,两组患者β-CTX、sCD44、FGF-2水平均较术后1 d升高,且正常组患者的β-CTX、FGF-2水平分别为(0.82±0.26)ng/mL、(30.00±7.65)ng/L,均高于延迟组[(0.61±0.15)ng/mL、(25.67±7.26)ng/L],而sCD44水平为(283.20±24.17)ng/mL,低于延迟组[(312.66±33.25)ng/mL],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,术后7 d EGF、CTRP3、β-CTX、sCD44、FGF-2表达均为影响上肢骨折患者愈合的独立危险因素(P<0.05)。经ROC曲线分析,术后7 d的EGF、CTRP3、β-CTX、sCD44水平表达均对上肢骨折患者正常愈合有较高的预测价值,曲线下面积(AUC)值分别为0.719、0.868、0.741、0.812。结论上肢骨折正常愈合患者EGF、CTRP3、β-CTX、FGF-2水平高于延迟组,而sCD44低于延迟组,EGF、CTRP3、β-CTX、sCD44水平表达均对上肢骨折患者正常愈合有较高的预测价值。Objective To explore the correlation of epidermal growth factor(EGF),C1q/TNF related protein 3(CTRP3),and bone metabolism levels with upper limb fracture healing.Methods Ninety patients with upper limb fractures admitted to Red Society Hospital affiliated to Xi'an Jiaotong University from June 2019 to November 2023 were prospectively selected as the research subjects.Based on the fracture healing situation 6 months after operation,they were divided into the normal group(n=67)and the delayed group(n=23).The levels of EGF,CTRP3,and bone metabolism related indicators[β-C-terminal telopeptide of type I collagen(β-CTx),soluble adhesion moleculeCD44(sCD44),fibroblast growth factor-2(FGF-2)]between two groups of patients before operation and 7 days after operation were compared.The factors affecting the normal healing of patients with upper limb fracture were analyzed by multivariate Logistic regression analysis.The predictive value of EGF,CTRP3,β-CTX,sCD44,and FGF-2 for normal healing of upper limb fractures was analyzed using the receiver operating characteristic(ROC)curve.Results At 7 days after operation,the levels of EGF and CTRP3 in the two groups were higher than those at 1 day after operation,and the levels of EGF and CTRP3 in the normal group were(0.98±0.16)and(217.85±51.05)pg/mL,respectively,which were higher than those in the delayed group[(0.87±0.12)and(144.62±41.95)pg/mL],and the differences were statistically significant(P<0.05).At 7 days after operation,the levels ofβ-CTX,sCD44 and FGF-2 in the two groups were higher than those at 1 day after operation,and the levels ofβ-CTX and FGF-2 in the normal group were(0.82±0.26)ng/mL and(30.00±7.65)ng/L,respectively,which were higher than those in the delayed group[(0.61±0.15)ng/mL,(25.67±7.26)ng/L],while the level of sCD44 was(283.20±24.17)ng/mL,which was lower than that in the delayed group[(312.66±33.25)ng/mL],the differences were statistically significant(P<0.05).According to Logistic regression analysis,the expression of EGF,CTRP3,β-CTX,sCD44,

关 键 词：上肢骨折 表皮生长因子 C1q/TNF相关蛋白3 Ⅰ型胶原羧基端肽β特殊序列 可溶性黏附分子CD44 成纤维细胞生长因子-2 

分 类 号：R683.41[医药卫生—骨科学]