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| 基因标志物评分预测骨质疏松性髋部骨折患者术后谵妄 |
| Gene marker score predicts postoperative delirium in patients with osteoporotic hip fractures |
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| DOI：10.3969/j.issn.1006-7108.2025.09.010 |
| 中文关键词: 骨质疏松性髋部骨折 术后谵妄 基因标志物 列线图 微阵列分析 |
| 英文关键词:osteoporotic hip fracture postoperative delirium genetic marker nomogram microarray analysis |
| 基金项目:江西省卫生健康委科技计划项目（202211655） |
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| 中文摘要: |
| 目的 构建基因标志物评分预测骨质疏松性髋部骨折（OHF）患者术后谵妄（POD）风险。方法 选择我院2022年1月至2024年1月收治的121例OHF患者为研究对象。对9例POD和9例无POD的OHF患者血浆mRNAs进行微阵列分析。使用Cytoscape构建蛋白质-蛋白质相互作用（PPI）网络，基于度中心性（DC）值筛选前25 %的核心基因并利用酶联免疫吸附法（ELISA）验证基因表达。通过最小绝对收缩和选择算子（LASSO）回归筛选并计算特征基因回归系数构建基因标志物评分，将其与临床数据结合构建预测OHF患者POD风险列线图。结果 POD和无POD患者微阵列数据识别出161个基因在POD患者血浆中表达上调，63个基因在POD患者血浆中表达下调。PPI网络中基于DC值发现前25 %核心基因有16个。ELISA验证表达后通过LASSO回归筛选并构建基因标志物评分：0.205×H3簇状组蛋白12（H3C12）表达量+0.055×整合素αX亚基（ITGAX）表达量?0.457×核糖体蛋白S4 Y-linked 1（RPS4Y1）表达量。基于基因标志物评分结合体质量指数（BMI）和血红蛋白（Hb）构建的列线图可有效预测OHF患者POD风险。结论 包含H3C12、ITGAX和RPS4Y1的基因标志物评分和BMI和Hb的列线图可高效预测OHF患者POD风险，为患者术后早期预防和干预提供新的指导思路。 |
| 英文摘要: |
| Objective A genetic marker score system was constructed to predict the risk of postoperative delirium (POD) in patients with osteoporotic hip fracture (OHF). Methods One hundred and twenty-one OHF patients admitted to our hospital from January 2022 to January 2024 were selected for the study. Microarray analysis of serum mRNAs was performed in 9 POD and 9 OHF patients without POD. Protein-protein interaction (PPI) networks were constructed using Cytoscape. The top 25% core genes were screened based on degree centrality (DC) values and gene expression was verified using enzyme-linked immunosorbnent assay (ELISA). Gene marker scores were constructed by least absolute shrinkage and selection operator (LASSO) regression screening and calculation of characteristic gene regression coefficients. They were combined with clinical data to construct a column-line graph for predicting the risk of POD in OHF patients. Results Microarray data from POD and POD-free patients identified 161 genes with up-regulated expression and 63 genes with down-regulated expression in the serum of POD patients. There were 16 core genes found in the top 25% based on DC values in the PPI network. The expression was verified using ELISA followed by LASSO regression screening and construction of the gene marker scores: 0.205 × H3 clustered Histone 12 (H3C12) expression + 0.055 × integrin subunit αX (ITGAX) expression - 0.457 × ribosomal protein S4 Y-linked 1 (RPS4Y1) expression. A column-line graph constructed based on gene marker scores combined with body mass index (BMI) and hemoglobin (Hb) was effective in predicting the risk of POD in OHF patients. Conclusion Genetic marker score containing H3C12, ITGAX, and RPS4Y1 and column line plots of BMI and Hb may efficiently predict the risk of POD in patients with OHF and provide a new guideline idea for early prevention and intervention in the postoperative period for patients. |
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