血清Cx43 miR-125a-5p对四肢骨折延迟愈合临床诊断价值

目的 探讨微小RNA-125a-5p(miR-125a-5p)、细胞间隙连接蛋白43(Cx43)在四肢骨折患者血清中的表达水平及与骨折延迟愈合的关系。方法 选取2018年1月至2021年12月秦皇岛市第一医院收治的188例四肢骨折患者为研究对象，其中骨折延迟愈合患者30例作为延迟组，正常愈合患者158例为对照组。收集两组一般资料，采用实时荧光定量PCR(qRT-PCR)法测定两组对象血清miR-125a-5p、Cx43水平；利用受试者工作特征(ROC)曲线评价Cx43、miR-125a-5p水平对四肢骨折延迟愈合的预测价值；logistic回归分析影响四肢骨折延迟愈合发生的危险因素。结果 本研究中188例四肢骨折患者共有30例发生延迟愈合，发生率为15.96%;术后6周、术后12周时，延迟组血清Cx43表达水平低于对照组，miR-125a-5p水平高于对照组(P<0.05);多因素logistic回归分析结果显示，Cx43(OR=0.127,95%CI:0.021～0.775)、miR-125a-5p(OR=3.056,95%CI:1.092～8.552)、年龄(OR=1.142...

The clinical diagnostic value of serum Cx43 and miR-125a-5p for delayed union of extremity fractures

Objective To investigate the expression of microRNA-125a-5p and connexins 43 (Cx43) in serum of patients with extremity fractures and their relationship with delayed fracture union.Methods A total of 188 patients with extremity fractures admitted to Qinhuangdao First Hospital from January 2018 to December 2021 were taken as the research objects. Among them 30 patients with delayed fracture union were regarded as the delayed group, and 158 patients with normal union were regarded as the control group. The general information was collected.Real-time fluorescence quantitative PCR (qRT-PCR) was performed to determine the levels of serum miR-125a-5p and Cx43.Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of Cx43 and miR-125a-5p levels on delayed union of extremity fractures.Logistic regression analysis was performed to analyze the risk factors for delayed union of extremity fractures.Results Among the 188 extremity fracture patients in this study, delayed union occurred in 30 cases, andthe incidence rate was 15.96%;6 weeks and 12 weeks after operation, the expression levels of serum Cx43 in the delayed group were lower than those in the control group, and the level of miR-125a-5p was higher than that in the control group (P<0.05).Multivariate logistic regression analysis showed that Cx43(OR=0.127, 95%CI:0.021~0.775), miR-125a-5p(OR=3.056, 95%CI:1.092~8.552), age(OR=1.142, 95%CI:1.008~1.294), smoking (OR=1.537, 95%CI:1.115~2.117), fracture type (OR=1.671, 95%CI:1.084~2.577), diabetes mellitus(OR=2.024, 95%CI:1.074~3.812), and osteoporosis (OR=1.525, 95%CI:1.128~2.062) were the factors that affected the delayed union of extremity fractures. ROC curve results showed that the area under the curve (AUC) of serum Cx43 combined with miR-125a-5p levels to predict delayed union in patients with extremity fractures 6 and 12 weeks after surgery was 0.944 and 0.964, respectively, which was higher than that detected by a single index.Conclusions The expression of Cx43 in serum of patients with delayed fracture union is down-regulated, and the expression of miR-125a-5p is up-regulated, both of which are risk factors for delayed fracture union. The combined detection of their expression levels has a high predictive value for delayed fracture union.