Changes and clinical significance of serum HMGB1 and TLR-2 levels in patients with postoperative infection of tibiofibular fractures
ZHANG Ludong
WANG Min
LI Jian
YI Cunguo
Abstract：Objective To explore the clinical value of changes in serum high mobility group protein B1 (HMGB1) and Toll like receptor-2 (TLR-2) levels in postoperative infection of tibiofibular fractures.Methods This study retrospectively select-ed 339 patients with tibiofibular fractures who underwent surgery in our hospital from January 2022 to January 2024 as sub-jects.The pathogen ofinfection was statistically analyzed,and the patients were dividedinto an infected group(52 cases)and an uninfected group (287 cases) based on their infection situation of all parts during hospitalization.ELISA method was ap-plied to detect serum HMGB1 and TLR-2 levels on the 1st and 3rd postoperative days.Logistic regression analysis was ap-plied to screen for factors affecting postoperative infection in tibiofibular fractures.ROC curve was applied to analyze the pre-dictive value of serum HMGB1 and TLR-2 levels on postoperative infection of tibiofibular fractures on the 3rd day after sur-gery.Results A total of 86 pathogenic strainswere isolated from 52 infected patients,with Escherichia coli accounting for the highest proportion (37.21％),followed by Candida albicans (24.42％) and Staphylococcus aureus (10.46％).The 86 strains of pathogens isolated after surgery mainly came from surgical site secretions (74.42％),followed by blood (12.79％).The levels of serum HMGB1 and TLR-2 on the 3rd day after operation,and the proportions of diabetes,injury to operation time ≥ 3 h,operation time ≥ 1.5 h in the infected group were higher than those in the uninfected group (P<0.05).Serum HMGB1 (OR=2.979) and TLR-2 (OR=3.014) on the third day after surgery were independent risk factors for postopera-tive infection in tibiofibular fractures (P<0.05).The AUCs of serum HMGB1 and TLR-2 on the third day after surgery predicted separately and in combination in postoperative infection of tibiofibular fractures were0.838,0.811,and 0.906.Conclusion The main pathogens causing postoperative infections in tibiofibular fractures were Escherichia coli and Candida albicans.Monitoring changes in serum HMGB1 and TLR-2 levels couldeffectively predict postoperative infections in tibiofib-ular fractures.
Keywords：tibiofibular fracturesinfectionhigh mobility group protein B1Toll like receptor-2
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 579-584 )