[1]马力,汪盛玉,韩军烨,等.长链非编码RNA HAGLR与微RNA-19a-3p对股骨颈骨折内固定术后骨折不愈合的影响[J].中医正骨,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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长链非编码RNA HAGLR与微RNA-19a-3p对股骨颈骨折内固定术后骨折不愈合的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年04期
页码:
1-6
栏目:
临床研究
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:
马力; 汪盛玉; 韩军烨; 付豪
(松滋市人民医院,湖北 松滋 434200)
Author(s):
MA Li; WANG Shengyu; HAN Junye; FU Hao
Songzi People's Hospital,Songzi 434200,Hubei,China
关键词:
股骨颈骨折;  骨折固定术; 内;  骨折; 不愈合;  RNA; 长链非编码;  微RNAs
Keywords:
femoral neck fractures;  fracture fixation; internal;  fractures; ununited;  RNA; long noncoding;  microRNAs
摘要:
目的:观察长链非编码RNA(long non-coding RNA,lncRNA)HAGLR与微RNA(microRNA,miRNA)-19a-3p对股骨颈骨折内固定术后骨折不愈合的影响。方法:回顾性分析采用切开复位AO中空加压螺钉内固定治疗的股骨颈骨折患者的病例资料,包括性别、年龄、基础疾病(高血压、糖尿病、冠心病)、损伤类型、骨折类型、骨折愈合情况,以及采用实时定量PCR检测法测得的外周血液中lncRNA HAGLR和miRNA-19a-3p表达量。按照术后骨折愈合情况分为愈合组和不愈合组。先对2组患者的相关信息进行单因素分析,再采用Logistic回归分析研究骨折不愈合的影响因素,最后采用受试者操作特征(receiver operating characteristic,ROC)曲线分析评价外周血液中lncRNA HAGLR与miRNA-19a-3p表达量对骨折不愈合的预测价值。结果:①骨折不愈合影响因素的单因素分析结果。共纳入141例患者,男73例、女68例。愈合组120例,不愈合组21例。2组患者年龄、损伤类型、骨折类型的比较,组间差异均有统计学意义(t=3.395,P=0.001; χ2=16.904,P=0.000; χ2=4.727,P=0.030)。术后4周、8周、12周,愈合组外周血液中lncRNA HAGLR表达量均高于不愈合组(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表达量均低于不愈合组(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骨折不愈合影响因素的多因素分析结果。将损伤类型、骨折类型以及术后4周外周血液中lncRNA HAGLR和miRNA-19a-3p表达量作为自变量,将骨折是否愈合作为因变量,进行Logistic回归分析,结果显示高能量损伤、骨折移位、术后4周外周血液中miRNA-19a-3p表达量是股骨颈骨折内固定术后骨折不愈合的危险因素(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),术后4周外周血液中lncRNA HAGLR表达量是股骨颈骨折内固定术后骨折不愈合的保护因素(β=-109.00,P=0.001,OR=0.000)。③lncRNA HAGLR和miRNA-19a-3p表达量对骨折不愈合的预测结果。ROC曲线分析结果显示,采用术后4周外周血液中lncRNA HAGLR和miRNA-19a-3p表达量预测骨折不愈合的灵敏度分别为61.67%、81.67%,特异度分别为80.95%、47.62%,曲线下面积分别为0.710(P=0.002)、0.673(P=0.012)。结论:股骨颈骨折内固定术后4周时外周血液中lncRNA HAGLR表达量下降、miRNA-19a-3p表达量升高提示骨折不愈合风险增加,这两项指标可用作预测股骨颈骨折内固定术后骨折不愈合的生物标志物。
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 本文编辑:郭毅曼)

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更新日期/Last Update: 1900-01-01