miR-24-3p、Smad5与骨质疏松性脊柱骨折患者PVP术后骨折愈合的相关性

Correlation between MiR-24-3p,Smad5 and Fracture Healing in Patients with Osteoporotic Spinal Fractures after PVP

目的探讨miR-24-3p、Smad5与骨质疏松性脊柱骨折患者经皮椎体成形术(percutaneous vertebro plasty,PVP)术后骨折愈合的相关性。方法选取2019年10月~2021年10月中国人民解放军陆军第七十二集团军医院收治的骨质疏松性脊柱骨折且接受PVP治疗的患者98例作为研究对象,并依照术后3个月骨折愈合情况将患者分为延迟组(n=26)和愈合组(n=72)。比较两组患者的miR-24-3p、Smad5 mRNA表达水平、骨密度(bone mineral density,BMD)情况以及骨折愈合相关指标,并进行相关性分析。结果两组患者术后3个月的miR-24-3p表达水平明显低于术后3天,且愈合组明显低于延迟组(P<0.05);两组患者术后3个月的Smad5 mRNA表达水平明显高于术后3天,且愈合组明显高于延迟组(P<0.05)。与愈合组比较,延迟组患者术后3个月腰椎BMD、股骨颈BMD、椎体前缘高度明显降低,而Cobb角变化、Oswestry功能障碍指数(oswestry disability index,ODI)、视觉模拟量表(visual analogue scale,VAS)评分均明显升高(P<0.05)。Pearson相关性分析显示,患者PVP术后3个月miR-24-3p与腰椎BMD、股骨颈BMD呈负相关,与Cobb角、ODI、VAS评分呈正相关(P<0.05);而Smad5 mRNA与腰椎BMD、股骨颈BMD、椎体前缘高度恢复率呈正相关,与Cobb角、ODI、VAS评分呈负相关(P<0.05)。miR-24-3p、Smad5mRNA ROC曲线下面积(area under the curve,AUC)分别为0.885、0.881。结论骨质疏松性脊柱骨折患者PVP术后发生骨折延迟愈合,可能与血清中miR-24-3p呈高表达、Smad5mRNA呈低表达有关。

Objective To investigate the correlation between miR-24-3p,Smad5 and fracture healing in patients with osteoporotic spinal fractures after percutaneous vertebro plasty(PVP).Methods A total of 98 patients with osteoporotic spinal fractures who received PVP treatment in Hospital of the 72nd Group Army of the PLA Army from October 2019 to October 2021 were selected as the research objects,and the patients were divided into delay group(n=26)and healing group(n=72)according to fracture healing at 3 months after operation.The mRNA expression levels of miR-24-3p and Smad5,bone mineral density(BMD)and fracture healing related indicators were compared between the two groups,and correlation analysis was performed.Results The expression level of miR-24-3p in the two groups at 3 months after operation was significantly lower than that at 3days after operation,and the healing group was significantly lower than that in the delayed group(P<0.05).The expression level of Smad5mRNA in the two groups at 3months after operation was significantly higher than that at 3days after operation,and the healing group was significantly higher than that in the delayed group(P<0.05).Compared with the healing group,the lumbar BMD,femoral neck BMD,and anterior vertebral height of the delayed group were significantly decreased at 3 months after operation,while the Cobb angle,oswestry disability index(ODI),and visual analogue scale(VAS)were significantly increased(P<0.05).Pearson correlation analysis showed that miR-24-3p was negatively correlated with lumbar BMD and femoral neck BMD,and positively correlated with Cobb angle,ODI and VAS at 3months after PVP(P<0.05).However,Smad5mRNA was positively correlated with lumbar BMD,femoral neck BMD,and anterior vertebral height recovery rate,and negatively correlated with Cobb angle,ODI,and VAS(P<0.05).The area under the ROC curve(AUC)of miR-24-3p and Smad5mRNA were 0.885 and 0.881,respectively.Conclusion Delayed fracture healing in patients with osteoporotic spinal fractures after PVP may be related to the high expression of miR-24-3p and low expression of Smad5mRNA in serum.