Predictive value of combined detection of serum microRNA-374b-5p,P-selectin and tumor necrosis factor receptor-associated factor 6 for postoperative deep vein thrombosis in patients with traumatic lower limb fractures
- VernacularTitle:血清微小RNA-374b-5p、P选择素、肿瘤坏死因子受体相关因子6联合检测对下肢创伤性骨折患者术后深静脉血栓形成的预测价值
- Author:
Xue WANG
1
;
Jingru WANG
;
Yan CUI
Author Information
- Keywords: traumatic lower limb fractures; deep vein thrombosis; microRNA-374b-5p; P-selectin; tumor necrosis factor receptor-associated factor 6; coagulation; inflammatory response; prediction model
- From: Journal of Clinical Medicine in Practice 2025;29(19):19-25
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the correlations of the expression levels of serum microR-NA-374b-5p(miR-374b-5p),P-selectin and tumor necrosis factor receptor-associated factor 6(TRAF6)with deep vein thrombosis(DVT)in patients with traumatic lower limb fractures,and to construct a multi-indicator Logistic regression model to establish a postoperative DVT risk prediction tool.Methods A total of 160 patients with traumatic lower limb fractures were selected as the study subjects and divided into DVT group(n=55)and non-DVT group(n=105)based on postoperative color Doppler ultrasound examination results.Clinical data of the patients were collected,and their coagulation and blood lipid indicators were tested.Real-time fluorescent quantitative polymerase chain reaction was used to detect the serum miR-374b-5p expression level within 24 hours postopera-tively.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum P-selectin and TRAF6 levels,and their relationships with short-term postoperative DVT were analyzed.Logis-tic regression analysis was conducted to identify the influencing factors of postoperative DVT in pa-tients with traumatic lower limb fractures,and a relevant model was established to assess the pa-tients' DVT risk.Results There were no statistically significant differences in demographic charac-teristics(gender,age and body mass index),underlying diseases(hypertension,diabetes and vari-cose veins),treatment-related factors(postoperative hemostatic drug use and fracture site),and lif-estyle habits(smoking history and alcohol consumption history)between the two groups(P＞0.05).The proportion of patients in the DVT group with a postoperative first ambulation time of less than 7 days was significantly lower than that in the non-DVT group,while the levels of D-dimer and fibrinogen degradation products were significantly higher in the DVT group than those in the non-DVT group(P＜0.05).The high-density lipoprotein cholesterol level in the DVT group was signifi-cantly lower than that in the non-DVT group(P＜0.05).The relative expression levels of serum miR-374b-5p and the levels of P-selectin and TRAF6 in the DVT group were significantly higher than those in the non-DVT group(P＜0.05).Logistic regression analysis revealed that a postopera-tive ambulation time of≥7 days,D-dimer,fibrinogen degradation products,high-density lipopro-tein cholesterol,relative expression level of miR-374b-5p as well as levels of P-selectin and TRAF6 were influencing factors for postoperative DVT in patients.Based on these findings,a postoperative DVT prediction model was established,which showed an area under the curve(AUC)of 0.977(95％CI:0.953 to 0.992)for predicting postoperative DVT in patients.Conclusion The serum levels of miR-374b-5p,P-selectin and TRAF6 are closely related to postoperative DVT in patients with traumatic lower limb fractures,and the prediction model established based on these factors has high predictive value.
