临床与病理杂志2025，Vol.45Issue(10)：1310-1317,8.DOI:10.11817/j.issn.2095-6959.2025.250723
急性牙髓炎患者根管治疗术后血清骨形态发生蛋白-2、可溶性B7-H3水平及其与术后疼痛评分、生存质量的相关性
Serum levels of bone morphogenetic protein-2 and soluble B7-H3 after root canal therapy in patients with acute pulpitis and their correlation with postoperative pain scores and quality of life
摘要
Abstract
Objective:Acute pulpitis is a common dental emergency and root canal therapy is the core treatment approach;however,postoperative pain is frequent,with substantial inter-individual variation in pain severity,which severely impairs postoperative quality of life.Currently,there is a lack of objective biological markers that can effectively predict postoperative pain and functional recovery in clinical practice.This study aims to investigate serum levels of bone morphogenetic protein-2(BMP-2)and soluble B7-H3(sB7-H3)after root canal therapy in patients with acute pulpitis,analyze their correlations with postoperative pain severity and quality of life,and evaluate the predictive value of each marker alone and in combination for postoperative pain and quality of life outcomes. Methods:A total of 100 patients with acute pulpitis treated at Shijiazhuang Second Hospital from January 2020 to June 2022 were enrolled(acute pulpitis group),and 100 healthy individuals undergoing physical examination were selected as a control group.At 3 months post-treatment,pain severity was assessed using the Visual Analogue Scale(VAS),and the acute pulpitis group was divided into a mild pain subgroup(n=65)and a severe pain subgroup(n=35).Postoperative quality of life was evaluated using a multidimensional scale covering psychological function,social function,masticatory function,and daily life,and patients were further classified into a high quality of life subgroup(n=74)and a low quality of life subgroup(n=26).Serum levels of BMP-2 and sB7-H3 before and after treatment were measured using enzyme-linked immunosorbent assay.Point-biserial correlation analysis was applied to examine associations between serum marker levels at 7 days post-procedure and pain severity as well as quality of life.Receiver operating characteristic curves were generated to evaluate the predictive value of 7-day postoperative serum levels of BMP-2 and sB7-H3 for postoperative pain severity and quality of life,and areas under the curve(AUCs)between models were compared using the DeLong test. Results:Serum BMP-2 levels in the acute pulpitis group were lower than those in the control group,whereas sB7-H3 levels were higher than those in the control group(both P<0.001).The severe pain subgroup showed lower BMP-2 levels and higher sB7-H3 levels compared with the mild pain subgroup(both P<0.001).The low quality of life subgroup had lower BMP-2 levels and higher sB7-H3 levels than the high quality of life subgroup(both P<0.001).Serum BMP-2 levels were negatively correlated with postoperative pain severity(r=-0.472,P<0.001)and positively correlated with quality of life(r=0.543,P<0.001).Serum sB7-H3 levels were positively correlated with postoperative pain severity(r=0.519,P<0.001)and negatively correlated with quality of life(r=-0.624,P<0.001).The combined model of BMP-2 and sB7-H3 yielded an AUC of 0.964 for predicting postoperative pain severity,outperforming models using BMP-2 alone(Zcombination-BMP-2=2.101,P=0.036)and sB7-H3 alone(Zcombination-sB7-H3=2.962,P=0.003).For predicting postoperative quality of life,the combined model achieved an AUC of 0.940,superior to models using BMP-2 alone(Zcombination-BMP-2=2.192,P=0.028)and sB7-H3 alone(Zcombination-sB7-H3=2.492,P=0.013). Conclusion:In patients with acute pulpitis,postoperative serum BMP-2 shows low expression in the severe pain and low quality of life subgroups,while sB7-H3 shows high expression in the severe pain and low quality of life subgroups.The combination of BMP-2 and sB7-H3 demonstrates a certain predictive value for postoperative pain severity and quality of life in patients with pulpitis.关键词
骨形态发生蛋白-2/可溶性B7-H3/牙髓炎/根管治疗/术后疼痛预测Key words
bone morphogenetic protein-2/soluble B7-H3/pulpitis/root canal therapy/postoperative pain prediction引用本文复制引用
张江畔,王会超,张亚宏..急性牙髓炎患者根管治疗术后血清骨形态发生蛋白-2、可溶性B7-H3水平及其与术后疼痛评分、生存质量的相关性[J].临床与病理杂志,2025,45(10):1310-1317,8.基金项目
河北省卫健委重点科技研究计划(20231634).This work was supported by the Key Science and Technology Research Program of Hebei Provincial Health Commission,China(20231634). （20231634）
