血清内皮素-1、白细胞介素-33与股骨颈骨折患者术后股骨头坏死发生的相关性

Correlation between serum endothelin-1,interleukin-33 and postoperative femoral head necrosis in patients with femoral neck fracture

目的 探讨血清内皮素-1(ET-1)、白细胞介素-33(IL-33)在股骨颈骨折(FNF)患者中的表达,并分析二者与患者术后股骨头坏死(FHN)发生的相关性。方法 将杭州市萧山区中医院2019年7月—2021年7月行内固定治疗的FNF患者纳入本次研究,共125例;于内固定术后1 d检测患者血清ET-1、IL-33水平及其他实验室指标[血清Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型前胶原氨基端延长肽(PINP)],并记录患者基线资料;术后随访6个月,采用X线摄片及磁共振(MRI)检查评估患者FHN发生情况;分析血清ET-1、IL-33与FNF患者术后FHN发生的相关性。结果 125例患者中26例发生FHN,占20.80%;发生组FNF复位质量差于未发生组,血清ET-1、IL-33水平均高于未发生组(P<0.05);2组其他资料比较,差异无统计学意义(P>0.05);采用点二列相关性分析,血清ET-1、IL-33水平与FNF患者术后发生FHN有关(r值分别为0.327、0.367,P<0.001);通过logistic回归分析检验,血清ET-1、IL-33过表达与FNF患者术后FHN有关(P<0.05);绘制受试者工作特征(ROC)曲线,结果显示,血清ET-1、IL-33水平单独及联合预测FNF患者术后发生FHN的AUC分别为0.725、0.734、0.836,均有一定价值,且联合预测的价值更高。结论 血清ET-1、IL-33过表达与FNF患者术后FHN发生密切相关,两指标过表达可提示FNF患者术后FHN的风险。

Objective To investigate the expression of serum endothelin-1(ET-1) and interleukin-33(IL-33) in patients with femoral neck fracture(FNF), and to analyze the correlation between them and postoperative femoral head necrosis(FHN). Methods A total of 125 patients with FNF who underwent internal fixation from July 2019 to July 2021 in Xiaoshan District Hospital of Traditional Chinese Medicine were included in this study;the levels of serum ET-1, IL-33 and other laboratory indexes [serum Beta C-terminal cross-linked telopeptides of type Ⅰ collagen(β-CTX), Procollagen type I N-terminal prepeptide(PINP)] were measured one day after internal fixation, and the baseline data of patients were recorded;patients were followed up for 6 months. The occurrence of FHN was evaluated by X-ray and magnetic resonance imaging(MRI);the correlation between serum ET-1, IL-33 levels and postoperative FHN in patients with FNF was mainly analyzed. Results FHN occurred in 26 of 125 patients, accounting for 20.80%;the quality of FNF reduction in the occurrence group was worse than that in the non-occurrence group, and the serum levels of ET-1 and IL-33 were higher than those in the non-occurrence group(P<0.05);there was no statistical significance on the difference in other data between the two groups(P>0.05);by point-biserial correlation analysis, the serum levels of ET-1 and IL-33 were related to FHN in patients with FNF(r=0.327, r=0.367, P<0.001);logistic regression analysis test showed that the overexpression of serum ET-1 and IL-33 was related to postoperative FHN in patients with FNF(P<0.05);the receiver operating characteristic(ROC) curve showed that the AUC of serum ET-1 or IL-33 alone and that of their combination to predict the occurrence of FHN in patients with FNF were respectively 0.725, 0.734 and 0.836, both of them had certain value, and the prediction value of joint detectionwas higher. Conclusion The overexpression of serum ET-1 and IL-33 is closely related to the occurrence of postoperative FHN in patients with FNF. The overexpression of the two indexes can indicate the risk of postoperative FHN in patients with FNF.