摘要
目的探讨老年骨质疏松性骨折(OPF)患者血清中正五聚蛋白3(PTX3)和信号素4D(Sema4d)对术后骨折再发的预测价值。方法选取2022年1月至2023年1月于该院就诊的168例老年OPF患者,根据术后骨折是否再发将患者分成非再发组(116例)和再发组(52例)。采用酶联免疫吸附试验检测血清中的PTX3、Sema4d水平,多因素Logistic回归分析骨折再发的影响因素,Pearson相关分析PTX3水平与Sema4d水平的相关性,受试者工作特征(ROC)曲线分析PTX3、Sema4d水平对术后骨折再发的预测价值,Z检验比较曲线下面积(AUC)。结果再发组与非再发组营养供给不足、穿刺部位、骨密度T值、骨折程度及血清中PTX3、Sema4d水平比较,差异有统计学意义(P<0.05);骨密度T值是术后骨折再发的独立保护因素,骨折程度及血清中PTX3、Sema4d水平是术后骨折再发的独立危险因素(P<0.05);再发组患者血清中PTX3水平与Sema4d呈正相关(r=0.415,P<0.001);PTX3、Sema4d二者联合诊断术后骨折再发的AUC为0.910(95%CI 0.857~0.949),优于血清PTX3、Sema4d单独诊断(Z_(二者联合-PTX3)=3.129、Z_(二者联合-Sema4d)=3.123,均P=0.002)。结论老年OPF术后骨折再发患者血清中PTX3、Sema4d水平升高,PTX3、Sema4d联合诊断老年OPF患者术后骨折再发具有较高价值,可作为早期诊断指标。
Objective To investigate the predictive value of pentraxin 3(PTX3)and semaphorin 4D(Sema4d)in serum for postoperative fracture recurrence in elderly patients with osteoporotic fracture(OPF).Methods A total of 168 elderly patients with OPF who were treated in this hospital from January 2022 to January 2023 were selected.According to the occurrence of postoperative fracture recurrence,the patients were divided into non-recurrence group(116 cases)and recurrence group(52 cases).The levels of PTX3 and Sema4d in serum were detected by enzyme-linked immunosorbent assay.The influencing factors of fracture recurrence were analyzed by multivariate Logistic regression,and the correlation between PTX3 level and Sema4d was analyzed by Pearson correlation.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of PTX3 and Sema4d levels for postoperative fracture recurrence,and Z test was used to compare the area under the curve(AUC).Results There were significant differences in nutritional deficiency,puncture site,bone mineral density T value,fracture degree and serum PTX3,Sema4d levels between recurrence group and non-recurrence group(P<0.05).Bone mineral density T value was an independent protective factor for postoperative fracture recurrence,and fracture degree,serum PTX3,Sema4d levels were independent risk factors for postoperative fracture recurrence(P<0.05).There was a positive correlation between serum PTX3 and Sema4d in recurrence group(r=0.415,P<0.001).The AUC of the combination of PTX3 and Sema4d in the diagnosis of postoperative fracture recurrence was 0.910(95%CI 0.857—0.949),which was better than that of serum PTX3 and Sema4d alone(Z_(combination-PTX3)=3.129,Z_(combination-Sema4D)=3.123,both P=0.002).Conclusion The serum levels of PTX3 and Sema4d are increased in elderly OPF patients with postoperative fracture recurrence.The combination of PTX3 and Sema4d has a high value in the diagnosis of postoperative fracture recurrence in elderly OPF patients,and can be used as an early diagnostic index.
作者
顾伏龙
姜江
沈水杰
王盛
GU Fulong;JIANG Jiang;SHEN Shuijie;WANG Sheng(Department of Orthopedics,Nantong Hospital of Traditional Chinese Medicine,Nantong,Jiangsu 226001,China;Department of Science and Education,Nantong Hospital of Traditional Chinese Medicine,Nantong,Jiangsu 226001,China)
出处
《国际检验医学杂志》
CAS
2024年第11期1343-1347,共5页
International Journal of Laboratory Medicine
基金
南通市科技计划项目(MS32017015)。
