胫骨骨折患者血清miR-378、ADAM10水平与术后延迟愈合的关系及预测能效  

Relationship Between Serum Mir-378 and Adam10 Levels and Postoperative Delayed Union in Patients with Tibial Fractures and Predictive Energy Efficiency

作　　者：杨震 李慧 宋龙强 YANG Zhen;LI Hui;SONG Longqiang(Department of Orthopedics,Huangdao District Traditional Chinese Medicine Hospital,Qingdao,Shandong 266500,China)

机构地区：[1]山东省青岛市黄岛区中医医院骨伤二科,山东青岛266500

出　　处：《转化医学杂志》2024年第5期772-776,786,共6页Translational Medicine Journal

基　　金：山东省医药卫生科技发展计划项目(202104070089)。

摘　　要：目的探讨胫骨骨折患者血清微小RNA-378(miR-378)、解整合素金属蛋白酶10(ADAM10)水平与术后延迟愈合的关系及预测能效。方法选取2020年6月至2023年12月在山东省青岛市黄岛区中医医院行内固定术的胫骨骨折患者150例,根据内固定术后是否延迟愈合分为延迟愈合组(n=42)和正常愈合组(n=108),采用实时荧光定量PCR和酶联免疫吸附法检测血清miR-378、ADAM10水平。以胫骨骨折患者术后延迟愈合为因变量,多因素非条件Logistic回归确定其影响因素,绘制受试者工作特征(ROC)曲线分析血清miR-378、ADAM10水平对其的预测能效。结果150例胫骨骨折患者术后延迟愈合发生率为28.00%(42/150)。延迟愈合组血清miR-378、ADAM10水平(1.04±0.17)、(1572.70±562.06)pg/mL高于正常愈合组(0.87±0.13)、(1050.23±291.67)pg/mL(t=5.984、5.732,P均<0.05)。胫骨骨折患者术后延迟愈合的独立危险因素为年龄(OR=1.053,95%CI:1.005~1.103,P=0.029)、miR-378(OR=2.362,95%CI:1.596~3.495,P<0.001)、ADAM10(OR=1.003,95%CI:1.002~1.005,P<0.001)。血清miR-378、ADAM10水平联合预测胫骨骨折患者术后延迟愈合的曲线下面积(AUC)为0.881(95%CI:0.818~0.928),大于血清miR-378、ADAM10水平单独预测的0.789(95%CI:0.715~0.851)、0.788(95%CI:0.714~0.851)(Z=2.912、2.686,P均<0.05)。结论胫骨骨折患者血清miR-378、ADAM10水平升高与术后延迟愈合密切相关,血清miR-378、ADAM10水平联合对其有较高的预测能效。Objective To investigate the relationship between serum microRNA-378(miR-378)and a disintegrin and metalloprotease 10(ADAM10)levels and postoperative delayed union in patients with tibial fractures and their predictive value.Methods A total of 150 tibial fracture patients who underwent internal fixation from June 2020 to December 2023 were selected and divided into the delayed union group(42 cases)and the normal healing group(108 cases)based on whether delayed union occurred after internal fixation.Serum miR-378 and ADAM10 levels were detected by real-time fluorescence quantitative PCR and enzyme-linked immunosorbent assay.Using delayed union after surgery in tibial fracture patients as the dependent variable,multivariate unconditional Logistic regression was employed to determine influencing factors,and the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficacy of serum miR-378 and ADAM10 levels.Results The incidence of postoperative delayed union in 150 tibial fracture patients was 28.00%(42/150).Serum miR-378(1.04±0.17)and ADAM10(1572.70±562.06)pg/mL levels in the delayed union group were significantly higher than those in the normal healing group(0.87±0.13)and(1050.23±291.67)pg/mL(t=5.984,5.732,all P<0.05).Independent risk factors for postoperative delayed union in tibial fracture patients included age(OR=1.053,95%CI:1.005 to 1.103,P=0.029),miR-378(OR=2.362,95%CI:1.596 to 3.495,P<0.001),and ADAM10(OR=1.003,95%CI:1.002 to 1.005,P<0.001).The area under the ROC curve for the combination of serum miR-378 and ADAM10 levels in predicting postoperative delayed union was 0.881(95%CI:0.818 to 0.928),which was significantly greater than that for miR-378(0.789,95%CI:0.715 to 0.851)or ADAM10(0.788,95%CI:0.714 to 0.851)alone(Z=2.912,2.686,all P<0.05).Conclusion Elevated serum miR-378 and ADAM10 levels are closely associated with delayed union after tibial fracture surgery.The combination of these markers demonstrates high predictive efficacy.

关 键 词：胫骨骨折 微小RNA-378 解整合素金属蛋白酶10 术后延迟愈合 预测能效 

分 类 号：R274.12[医药卫生—中医骨伤科学]