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骨形态发生蛋白-7、血栓素 A2 和护骨素对桡骨远端骨折患者预后的预测价值。

Predictive value of bone morphogenetic protein-7, thromboxane A2, and osteoprotegerin for prognosis of patients with distal radius fractures.

机构信息

Department of Emergency Surgery, Trauma Center, The First People's Hospital of Lianyungang, Lianyungang, China.

出版信息

Jt Dis Relat Surg. 2023 May 25;34(2):279-288. doi: 10.52312/jdrs.2023.1043.

Abstract

OBJECTIVES

This study aims to investigate the predictive value of bone morphogenetic protein-7 (BMP-7), thromboxane A2 (TXA2), and osteoprotegerin (OPG) for the prognosis of patients with distal radius fractures.

PATIENTS AND METHODS

Between January 2021 and January 2022, a total of 124 patients (71 males, 53 females; mean age: 49.8±5.1 years; range, 34 to 68 years) with distal radius fractures were included in the fracture group. Healthy volunteers receiving physical examination in our hospital in the same period were included in the control group (n=50; 29 males, 21 females; mean age: 50.1±5.4 years; range, 35 to 68 years). The expressions of BMP-7, TXA2, and OPG in the peripheral blood were detected. In the fracture group, 124 patients underwent internal fixation after inclusion and followed for six months. The prognosis was evaluated based on the Gartland & Werley scoring system for wrist joint function. The factors influencing prognosis were analyzed, and the predictive values of BMP-7, TXA2, and OPG were calculated.

RESULTS

Age, fracture classification, early loss of palmar tilt, late loss of palmar tilt, time to return to exercise after surgery, BMP-7, TXA2, and OPG were all factors influencing the prognosis (p<0.05). For predicting the prognosis, the area under the ROC curve of BMP-7 + TXA2 + OPG (0.928) was significantly larger than those of BMP-7 (0.810), TXA2 (0.856) and OPG (0.823) alone, and BMP-7 + TXA2 + OPG had the highest predictive efficiency. The BMP-7 was negatively correlated with TXA2 (r=-0.471), but positively correlated with OPG (r=0.437).

CONCLUSION

The combined detection of BMP-7, OPG, and TXA2 is highly valuable for predicting the prognosis of patients with distal radius fractures.

摘要

目的

本研究旨在探讨骨形态发生蛋白-7(BMP-7)、血栓素 A2(TXA2)和护骨素(OPG)对桡骨远端骨折患者预后的预测价值。

患者与方法

2021 年 1 月至 2022 年 1 月,共纳入 124 例桡骨远端骨折患者(71 例男性,53 例女性;平均年龄:49.8±5.1 岁;范围 34 至 68 岁)为骨折组。同期我院体检的健康志愿者纳入对照组(n=50;29 例男性,21 例女性;平均年龄:50.1±5.4 岁;范围 35 至 68 岁)。检测外周血中 BMP-7、TXA2 和 OPG 的表达。骨折组患者纳入后均行内固定治疗,并随访 6 个月。根据腕关节功能 Gartland & Werley 评分系统评估预后。分析影响预后的因素,并计算 BMP-7、TXA2 和 OPG 的预测价值。

结果

年龄、骨折分型、早期掌倾角丢失、晚期掌倾角丢失、术后恢复运动时间、BMP-7、TXA2 和 OPG 均为影响预后的因素(p<0.05)。预测预后时,BMP-7+TXA2+OPG 的 ROC 曲线下面积(0.928)明显大于 BMP-7(0.810)、TXA2(0.856)和 OPG(0.823)的单独预测值,BMP-7+TXA2+OPG 具有最高的预测效率。BMP-7 与 TXA2 呈负相关(r=-0.471),与 OPG 呈正相关(r=0.437)。

结论

联合检测 BMP-7、OPG 和 TXA2 对桡骨远端骨折患者的预后具有重要的预测价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf3a/10367170/54b4c997b29c/JDRS-2023-34-2-279-288-F1.jpg

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