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目的 探讨血清胶原蛋白Ⅰ/Ⅲ比值联合脯氨酸-4-羟化酶α1亚基(P4HA1)与增生性瘢痕修复的相关性，并评估其预测价值。方法 纳入105例增生性瘢痕患者，根据入组时温哥华瘢痕量表(VSS)评分分为低VSS评分组(≤5分，42例)、中VSS评分组(6～8分，38例)和高VSS评分组(≥9分，25例)。检测血清ColⅠ型、Ⅲ型胶原蛋白及P4HA1水平，分析其与瘢痕修复程度的相关性。应用Logistic回归筛选独立危险因素，绘制ROC曲线评估其区分效能，并构建Nomogram列线图模型。结果 低VSS评分组血清ColⅠ/Ⅲ比值及P4HA1水平显著低于中、高VSS评分组(P<0.001)。ColⅠ/Ⅲ比值与VSS总分呈显著正相关(r=0.756,P<0.001)。多因素分析显示，ColⅠ/Ⅲ比值(OR=3.521)和P4HA1水平(OR=2.740)是瘢痕修复程度的独立关联因素。联合评估模型的AUC为0.918,优于单一指标，校准曲线显示模型预测值与实际分组吻合良好。结论 血清ColⅠ/Ⅲ比值联合P4HA1与增生性瘢痕修复程度密切相关，联合预测模型及列线图可有效预测瘢痕修复程度。
Abstract：Objective To investigate the correlation between serum collagen Ⅰ/Ⅲ ratio combined with proline-4-hydroxylase alpha 1 subunit(P4HA1) and hypertrophic scar repair, and to explore its predictive value.Methods A total of 105 patients with hypertrophic scars were included and divided into low VSS score group(≤5 points, 42 cases),medium VSS score group(6-8 points, 38 cases),and high VSS score group(≥9 points, 25 cases) based on their Vancouver Scar Scale(VSS) scores at enrollment.Serum levels of type Ⅰ collagen, type Ⅲ collagen, and P4HA1 were measured.Their correlation with the degree of scar repair was analyzed.Logistic regression was used to screen independent associated factors, and the receiver operating characteristic(ROC) curve was plotted to evaluate the differentiation performance.A nomogram model was constructed.Results The serum Col Ⅰ/Ⅲ ratio and P4HA1 levels in the low VSS score group were significantly lower than those in the medium and high VSS score groups(P<0.001).The Col Ⅰ/Ⅲ ratio was significantly positively correlated with the total VSS score(r=0.756,P<0.001).Multivariate analysis showed that the Col Ⅰ/Ⅲ ratio(OR=3.521) and P4HA1 level(OR=2.740) were independent factors associated with the degree of scar repair(high VSS score).The AUC of the combined evaluation model was 0.918,which was superior to that of a single indicator.The calibration curve indicated good agreement between the predicted probability and the actual grouping.Conclusion The serum Col Ⅰ/Ⅲ ratio combined with P4HA1 is closely related to the degree of hypertrophic scar repair, and the combined prediction model and nomogram can effectively predict the degree of scar repair.
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基本信息:
中图分类号:R622
引用信息:
[1]欧阳钟石,黄剑锋.血清胶原蛋白Ⅰ/Ⅲ比值联合P4HA1与增生性瘢痕修复的相关性分析[J].中国实验诊断学,2026,30(05):666-672.
基金信息:
北京市医院管理局专业发展计划项目(ZYLL202180)
2026-05-25
2026-05-25