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Abstract Objective To analyze the effect of serum vascular endothelial growth factor(VEGF) and vascular cell adhesion molecule-1(VCAM-1) levels on delayed healing of patients with femoral neck fracture，and to evaluate the predictive value of each index in delayed healing.Methods The clinical data of 189 patients with femoral neck fracture who completed treatment and postoperative follow-up in the Sixth Affiliated Hospital of Xinjiang Medical University from March 2017 to May 2019 were retrospectively analyzed.40 patients with delayed healing after femoral neck fracture surgery were included in delayed healing group，40 patients with good healing were included in the non-delayed healing group.the data of 40 healthy people who received routine physical examination and were confirmed as healthy people in the same period were retrospectively selected as the healthy control group.All the patients received routine examination and laboratory related index examination at admission，and the examination results were complete，the detection results of levels of serum VEGF and VCAM-1 in three groups were mainly recorded at admission.After 4，8 and 12 weeks of surgery，the levels of serum VEGF and VCAM-1 of femoral neck fracture patients were detected and compared.The correlation between serum indexes after at different time after surgery was analyzed.The effect of changes of serum levels in perioperative period on delayed healing after femoral neck fracture surgery was analyzed.The Receiver Operating Characteristic (ROC) curve was used to test the predictive value of serum indexes at different time for delayed healing.Results On admission，the level of serum VEGF in 80 patients with femoral neck fracture was lower than that in control group，and the level of VCAM-1 was higher than that in control group (P＜0.05).The level of VEGF in delayed healing group at different time after surgery was lower than that in non-delayed healing group，and the level of VCAM-1 was higher than that in non-delayed healing group (P＜0.05).The levels of serum VEGF had negative correlation with VCAM-1 in patients with femoral neck fracture 4，8 weeks after surgery (r=0.513，P＜0.05)，and the correlation was the strongest at 4 weeks of surgery.There was no correlation between VEGF and VCAM-1 after 12 weeks of surgery.The results of linear regression analysis showed that the changes of serum VEGF and VCAM-1 levels in perioperative period may be the influencing factors of postoperative delayed healing in patients with femoral neck fracture (P＜0.05).At different time after surgery，the serum VEGF and VCAM-1 levels had certain predictive value for delayed healing after femoral neck fracture surgery (all AUC>0.7，P＜0.05)，and the predictive value was the highest 8 weeks after surgery，and the corresponding areas under the curve were：0.766，0.781.Conclusion The postoperative serum VEGF and VCAM-1 interactions in patients with femoral neck fracture are closely related to postoperative delayed healing，which may be the influencing factor of postoperative delayed healing.The dynamic monitoring of serum VEGF and VCAM-1 levels at different time after surgery can well predict the risk of delayed healing of fracture，guide clinical rational prevention and treatment，and reduce the occurrence of delayed healing.
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