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[1]馬力,汪盛玉,韓軍燁,等.長鏈非編碼RNA HAGLR與微RNA-19a-3p對股骨頸骨折內固定術后骨折不愈合的影響[J].中醫(yī)正骨,2023,35(04):1-6.
　MA Li,WANG Shengyu,HAN Junye,et al.Effects of long non-coding RNA HAGLR and microRNA-19a-3p on bone nonunion after internal fixation of femoral neck fractures[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(04):1-6.
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長鏈非編碼RNA HAGLR與微RNA-19a-3p對股骨頸骨折內固定術后骨折不愈合的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年04期
頁碼:
1-6
欄目:
臨床研究
出版日期:
2023-04-20

文章信息/Info

Title:
Effects of long non-coding RNA HAGLR and microRNA-19a-3p on bone nonunion after internal fixation of femoral neck fractures
作者:
馬力; 汪盛玉; 韓軍燁; 付豪
(松滋市人民醫(yī)院,湖北 松滋 434200)
Author(s):
MA Li; WANG Shengyu; HAN Junye; FU Hao
Songzi People's Hospital,Songzi 434200,Hubei,China
關鍵詞:
股骨頸骨折;  骨折固定術; 內;  骨折; 不愈合;  RNA; 長鏈非編碼;  微RNAs
Keywords:
femoral neck fractures;  fracture fixation; internal;  fractures; ununited;  RNA; long noncoding;  microRNAs
摘要:
目的:觀察長鏈非編碼RNA(long non-coding RNA,lncRNA)HAGLR與微RNA(microRNA,miRNA)-19a-3p對股骨頸骨折內固定術后骨折不愈合的影響。方法:回顧性分析采用切開復位AO中空加壓螺釘內固定治療的股骨頸骨折患者的病例資料,包括性別、年齡、基礎疾病(高血壓、糖尿病、冠心病)、損傷類型、骨折類型、骨折愈合情況,以及采用實時定量PCR檢測法測得的外周血液中l(wèi)ncRNA HAGLR和miRNA-19a-3p表達量。按照術后骨折愈合情況分為愈合組和不愈合組。先對2組患者的相關信息進行單因素分析,再采用Logistic回歸分析研究骨折不愈合的影響因素,最后采用受試者操作特征(receiver operating characteristic,ROC)曲線分析評價外周血液中l(wèi)ncRNA HAGLR與miRNA-19a-3p表達量對骨折不愈合的預測價值。結果:①骨折不愈合影響因素的單因素分析結果。共納入141例患者,男73例、女68例。愈合組120例,不愈合組21例。2組患者年齡、損傷類型、骨折類型的比較,組間差異均有統(tǒng)計學意義(t=3.395,P=0.001; χ2=16.904,P=0.000; χ2=4.727,P=0.030)。術后4周、8周、12周,愈合組外周血液中l(wèi)ncRNA HAGLR表達量均高于不愈合組(0.79±0.20,0.63±0.15,t=3.494,P=0.001; 0.87±0.17,0.75±0.16,t=3.009,P=0.003; 0.95±0.16,0.87±0.19,t=2.054,P=0.042),miRNA-19a-3p表達量均低于不愈合組(1.19±0.29,1.40±0.30,t=3.046,P=0.001; 1.13±0.25,1.27±0.27,t=2.340,P=0.003; 1.03±0.22,1.18±0.20,t=2.919,P=0.042)。②骨折不愈合影響因素的多因素分析結果。將損傷類型、骨折類型以及術后4周外周血液中l(wèi)ncRNA HAGLR和miRNA-19a-3p表達量作為自變量,將骨折是否愈合作為因變量,進行Logistic回歸分析,結果顯示高能量損傷、骨折移位、術后4周外周血液中miRNA-19a-3p表達量是股骨頸骨折內固定術后骨折不愈合的危險因素(β=2.582,P=0.005,OR=1.423; β=1.734,P=0.011,OR=1.272; β=136.44,P=0.001,OR=23.698),術后4周外周血液中l(wèi)ncRNA HAGLR表達量是股骨頸骨折內固定術后骨折不愈合的保護因素(β=-109.00,P=0.001,OR=0.000)。③lncRNA HAGLR和miRNA-19a-3p表達量對骨折不愈合的預測結果。ROC曲線分析結果顯示,采用術后4周外周血液中l(wèi)ncRNA HAGLR和miRNA-19a-3p表達量預測骨折不愈合的靈敏度分別為61.67%、81.67%,特異度分別為80.95%、47.62%,曲線下面積分別為0.710(P=0.002)、0.673(P=0.012)。結論:股骨頸骨折內固定術后4周時外周血液中l(wèi)ncRNA HAGLR表達量下降、miRNA-19a-3p表達量升高提示骨折不愈合風險增加,這兩項指標可用作預測股骨頸骨折內固定術后骨折不愈合的生物標志物。
Abstract:
Objective:To observe the effects of long non-coding RNA(lncRNA)HAGLR and microRNA(miRNA)-19a-3p on bone nonunion after internal fixation of femoral neck fractures.Methods:The medical data of patients with femoral neck fractures treated with open reduction and internal fixation using AO hollow compression screws were retrospectively analyzed,including gender,age,underlying diseases(hypertension,diabetes,and coronary heart disease),injury type,fracture type,and fracture healing outcome.Real-time quantitative PCR was used to detect the expression levels of lncRNA HAGLR and miRNA-19a-3p in the peripheral blood.The patients were divided into a union group and a nonunion group according to the postoperative fracture healing outcomes.Firstly,univariate analysis was performed on the relevant information of patients in the two groups,followed by Logistic regression analysis for the influencing factors of bone nonunion.Finally,the receiver operating characteristic(ROC)curve was used to analyze and evaluate the predictive value of the expression levels of lncRNA HAGLR and miRNA-19a-3p in the peripheral blood for bone nonunion.Results:①Univariate analysis results of factors affecting bone nonunion.A total of 141 patients were involved,including 73 males and 68 females.There were 120 patients in the union group and 21 patients in the nonunion group.There were statistically significant differences in age,injury type,and fracture type between the two groups(t=3.395,P=0.001; χ2=16.904,P=0.000; χ2=4.727,P=0.030).At 4,8,and 12 weeks after surgery,the expression levels of lncRNA HAGLR in the peripheral blood of the union group were higher than those in the nonunion group(0.79±0.20 vs 0.63±0.15,t=3.494,P=0.001; 0.87±0.17 vs 0.75±0.16,t=3.009,P=0.003; 0.95±0.16 vs 0.87±0.19,t=2.054,P=0.042),while the expression levels of miRNA-19a-3p in the union group were lower than those in the nonunion group(1.19±0.29 vs 1.40±0.30,t=3.046,P=0.001; 1.13±0.25 vs 1.27±0.27,t=2.340,P=0.003; 1.03±0.22 vs 1.18±0.20,t=2.919,P=0.042).②Multivariate analysis results of factors affecting bone nonunion.Logistic regression analysis was carried out with injury type,fracture type,and expression levels of lncRNA HAGLR and miRNA-19a-3p in the peripheral blood at 4 weeks after surgery as independent variables and bone union/nonunion as the dependent variable.The results showed that high-energy injury,fracture displacement,and expression level of miRNA-19a-3p in the peripheral blood at 4 weeks after surgery were risk factors for bone nonunion of femoral neck fractures treated with internal fixation(β=2.582,P=0.005,OR=1.423; β=1.734,P=0.011,OR=1.272; β=136.44,P=0.001,OR=23.698),while the expression level of lncRNA HAGLR in the peripheral blood at 4 weeks after surgery was the protective factor for bone nonunion of femoral neck fractures treated with internal fixation(β=-109.00,P=0.001,OR=0.000).③Predictive results of lncRNA HAGLR and miRNA-19a-3p expre-ssion levels for bone nonunion of fractures.The results of ROC curve analysis showed that the sensitivity for predicting bone nonunion of fractures using lncRNA HAGLR and miRNA-19a-3p expression levels in the peripheral blood at 4 weeks after surgery was 61.67% and 81.67%,respectively,with specificities of 80.95% and 47.62%.The areas under curve were 0.710(P=0.002)and 0.673(P=0.012),respectively.Conclusion:The decreased expression of lncRNA HAGLR and increased expression of miRNA-19a-3p in the peripheral blood at 4 weeks after internal fixation of femoral neck fractures suggest an increased risk of bone nonunion.These two indicators can be used as biological markers to predict bone nonunion after internal fixation of femoral neck fractures.

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(收稿日期:2022-01-27 本文編輯:郭毅曼)

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更新日期/Last Update: 1900-01-01