血清LRP6、PTRF水平对胫骨骨折患者术后骨折愈合情况的预测价值  

Prognostic Value of Serum LRP6,PTRF on Fracture Healing in Cases with Tibial Fracture after Operation

作　　者：王臣 田彪 徐贺轩 赵亚菲 赵吉堂 WANG Chen;TIAN Biao;XU Hexuan;ZHAO Yafei;ZHAO Jitang(Department of Orthopedics,Cangzhou People's Hospital,Cangzhou,Hebei 061000,China)

机构地区：[1]沧州市人民医院骨科,河北沧州061000

出　　处：《转化医学杂志》2025年第3期45-49,共5页Translational Medicine Journal

基　　金：河北省2024年度医学科学研究课题计划(20241451)。

摘　　要：目的探讨血清低密度脂蛋白受体相关蛋白6(LRP6)、聚合酶1及转录释放因子(PTRF)水平对胫骨骨折(TF)患者术后骨折愈合情况的预测价值。方法选取2021年3月至2024年2月沧州市人民医院收治的117例TF患者。随访4个月,根据术后骨折愈合情况并将其分为正常愈合组(96例)和延迟愈合组(21例)。比较两组患者血清LRP6、PTRF水平;采用受试者工作特性(ROC)曲线评估血清LRP6、PTRF对TF患者骨折愈合情况的预测价值;采用多因素Logistic回归分析探讨TF患者骨折愈合影响因素。结果延迟愈合组血清LRP6、PTRF水平均显著低于正常愈合组(P<0.05)。血清LRP6、PTRF及二者联合预测TF患者术后骨折愈合情况的曲线下面积(AUC)分别为0.872(95%CI:0.802~0.924)、0.745(95%CI:0.693~0.797)、0.903(95%CI:0.851~0.955)。延迟愈合组年龄、糖尿病史占比、开放性骨折占比、术后完全负重时间≥3个月占比、术后合并局部感染占比、术后合并骨筋膜室综合征占比均显著大于正常愈合组(P<0.05)。有糖尿病史(OR=2.115,95%CI:1.437~3.112)、术后合并局部感染(OR=2.380,95%CI:1.568~3.613)、术后合并骨筋膜室综合征(OR=2.529,95%CI:1.669~3.833)、LRP6<17.26 ng/m L(OR=0.300,95%CI:0.189~0.476)、PTRF<35.52 ng/L(OR=0.406,95%CI:0.270~0.610)是TF患者术后骨折延迟愈合的独立危险因素(P<0.05)。结论血清LRP6、PTRF对TF患者术后骨折愈合情况具有一定的预测价值,且二者联合预测的价值更高。Objective To investigate the predictive value of serum levels of low density lipoprotein receptor-associated protein 6(LRP6),polymerase 1 and transcription release factor(PTRF)on fracture healing in patients with tibial fracture(TF)after surgery.Methods 117 cases with TF from March 2021 to February 2024 were selected.The patients were followed up for 4 months and divided into the normal healing group(n=96)and the delayed healing group(n=21).Serum LRP6 and PTRF levels were compared between the two groups.The predictive value of serum LRP6 and PTRF for fracture healing in patients with TF was evaluated by ROC.The influencing factors of postoperative fracture healing in TF patients were explored using multivariate Logistic regression.Results The serum levels of LRP6 and PTRF in the delayed healing group were lower than those in the normal healing group(P<0.05).The area under the curve(AUC)(95%CI)of serum LRP6,PTRF and their combination in predicting postoperative fracture healing in TF patients was 0.872(0.802-0.924),0.745(0.693-0.797)and 0.903(0.851-0.955),respectively.The delayed healing group had higher proportions of age,diabetes history,open fracture,complete weight-bearing time≥3 months,postoperative local infection and postoperative osteofascial compartment syndrome compared to the normal healing group(P<0.05).Multivariate analysis showed that diabetes history(OR=2.115,95%CI:1.437-3.112),postoperative local infection(OR=2.380,95%CI:1.568-3.613),postoperative osteofascial compartment syndrome(OR=2.529,95%CI:1.669-3.833),LRP6<17.26 ng/mL(OR=0.300,95%CI:0.189-0.476),and PTRF<35.52 ng/L(OR=0.406,95%CI:0.270-0.610)were independent risk factors for delayed fracture healing(P<0.05).Conclusion Serum LRP6 and PTRF have predictive value for postoperative fracture healing in TF patients,with higher predictive power when combined.

关 键 词：胫骨骨折 骨折愈合 低密度脂蛋白受体相关蛋白6 聚合酶1和转录释放因子 

分 类 号：R683.4[医药卫生—骨科学]