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目的:利用同位素标记相对和绝对定量(iTRAQ)技术分析寻找单纯股骨骨折和股骨骨折合并颅脑损伤患者早期差异表达基因。方法:收集2019年5月至2020年5月就诊于河北医科大学第二医院骨科诊断为颅脑损伤合并股骨骨折患者和单纯股骨骨折患者各5例，分别取其伤后第1天和第3天的血清，应用iTRAQ技术比较两组患者血清蛋白组学的差异，用n T-test检验对蛋白质定量结果进行统计分析。n 结果:两组两个时间点均上调差异表达基因涉及的KEGG通路包括蛋白酶体、Wnt信号通路和HIF-1信号通路(n P<0.05)。根据PPI可视化网络互作分析，各差异基因在第1天和第3天均上调且密切交互的基因依次为蛋白酶体亚单位α2型(PSMA2)第1天实验组高于对照组[(236.40±15.08) 比 (77.56±3.86)，n F＝0.316，n P<0.05]，第3天实验组高于对照组[(376.20±10.69) 比 (80.14±6.56)，n F＝1.191，n P<0.05]，差异有统计学意义、纤溶酶原激活物抑制物1型(SERPINE1)第1天实验组高于对照组[(107.14±7.47) 比 (49.50±4.53)，n F＝1.566，n P<0.05]，第3天实验组高于对照组[(78.74±8.67) 比 (33.40±3.85)，n F＝4.605，n P<0.05]、原肌球蛋白4(TPM4)第1天实验组高于对照组[(207.40±11.73) 比 (80.60±6.27)，n F＝0.010，n P<0.05]，差异有统计学意义，第3天实验组高于对照组[(4 230.18±182.35) 比 (1 325.66±96.43)，n F＝2.057，n P<0.05]，差异有统计学意义、胰岛素样生长因子(IGF-1)第1天实验组高于对照组[(4 974.81±163.97) 比 (978.82±110.92)，n F＝0.343，n P<0.05]，差异有统计学意义，第3天实验组高于对照组[(907.46±95.98) 比 (355.51±21.95)，n F＝4.240，n P<0.05]，差异有统计学意义、蛋白酶体亚单位α-4型(PSMA4)第1天实验组高于对照组[(1 276.51±128.59) 比 (586.86±72.51)，n F＝2.981，n P<0.05]，差异有统计学意义，第3天实验组高于对照组[(1 648.67±107.21) 比 (541.43±55.93)，n F＝1.559，n P<0.05]，差异有统计学意义，和肌球蛋白调节轻链10(MYL10)第1天实验组高于对照组[(118.84±12.78) 比 (51.43±5.48)，n F＝4.139，n P<0.05]，差异有统计学意义，第3天实验组高于对照组[(168.14±12.12) 比 (58.01±6.07)，n F＝4.063，n P<0.05]，差异有统计学意义。n 结论:SERPINE1、TPM4、MYL10、IGF-1等基因可能与早期颅脑损伤后骨折愈合加快密切相关，Wnt信号通路和HIF-1信号通路在其中发挥重要作用。“,”Objective:To search for early differentially expressed genes in patients with femoral fracture alone and femoral fracture combined with craniocerebral injury by isotope labelling relative and absolute quantitative (iTRAQ) technique.Methods:In May 2019-May 2020 in clinic in the second hospital, hebei medical university during the diagnosis of traumatic brain injury patients with femoral fractures and simple femoral fracture patients, 5 cases were taken its serum 1 and 3 days after injury, using iTRAQ technology analysis comparing the difference between the two groups of patients with serum proteomics, using n T-test for protein quantitative test results were analyzed.n Results:KEGG pathways involved in up-regulation of differentially expressed genes at two time points in both groups included proteasome, Wnt signaling pathway and HIF-1 signaling pathway (n P<0.05). According to PPI visual network interaction analysis, the genes that were up-regulated and closely interacting on the first and third day were proteasome subunit α2 (PSMA2) in the experimental group was higher than that in the control group on the first day [(236.40±15.08) vs. (77.56±3.86),n F=0.316, n P<0.05]. On day 3, the experimental group was higher than the control group [(376.20±10.69) vs. (80.14±6.56),n F=1.191, n P<0.05]. Plasminogen activator inhibitor type 1 (SERPINE1) on day 1 was higher in the experimental group than the control group [(107.14±7.47) vs. (49.5±4.53),n F=1.566, n P<0.05], the experimental group was higher than the control group on day 3 [(78.74±8.67) vs. (33.40±3.85),n F=4.605, n P<0.05], tropomyosin 4 (TPM4) in the experimental group was higher than that in the control group on day 1 [(207.40±11.73) vs. (80.60±6.27),n F=0.010, n P<0.05], On day 3, the experimental group was higher than the control group [(4 230.18±182.35) vs. (1 325.66±96.43),n F=2.057, n P<0.05], the experimental group was higher than the control group on day 1 [(4974.81±163.97) vs. (978.82±110.92),n F=0.343, n P<0.05], on the third day, the experimental group was higher than the control group [(907.46±95.98) vs. (355.51±21.95),n F=4.240, n P<0.05]. The proteasome subunit α-4 type (PSMA4) in the experimental group was higher than that in the control group on day 1 [(1 276.51±128.59) vs. (586.86±72.51),n F=2.981, n P<0.05]. On day 3, the experimental group was higher than the control group [(1 648.67±107.21) vs. (541.43±55.93),n F=1.559, n P<0.05] and myosin regulated light chain 10 (MYL10) on day 1 were higher in the experimental group than in the control group [(118.84±12.78) vs. (51.43±5.48),n F=4.139, n P<0.05]. On day 3, the experimental group was higher than the control group [(168.14±12.12) vs. (58.01±6.07),n F=4.063, n P<0.05].n Conclusion:SERPINE1, TPM4, MYL10, IGF-1 and other genes may be closely related to accelerated fracture healing after early head injury, Wnt and HIF-1 signaling pathway play an important role in this process.