外周血单个核细胞中NF-κB mRNA表达和血清IL-6水平与TKA术后DVT的关系  

Relationship between Expression of NF-κB mRNA in Peripheral Blood Mononuclear Cells and Serum IL-6 Level and DVT after TKA

作　　者：严志强 解绪红 冯凌思[1] 刘永轶[2] YAN Zhiqiang;XIE Xuhong;FENG Lingsi;LIU Yongyi(Foshan Gaoming District People’s Hospital,Foshan 528500,China;不详)

机构地区：[1]广东省佛山市高明区人民医院,广东佛山528500 [2]广州市第一人民医院

出　　处：《中国医学创新》2021年第18期1-5,共5页Medical Innovation of China

基　　金：2018年佛山市医学类科技攻关项目(2018AB001854)。

摘　　要：目的:探讨外周血单个核细胞(PBMC)中核因子-κB(NF-κB)mRNA表达和血清白介素-6(IL-6)水平与膝关节置换术(TKA)术后下肢深静脉血栓形成(DVT)的关系。方法:选择2017年4月-2021年3月在广东省佛山市高明区人民医院行TKA的123例患者作为研究对象,术后根据彩超诊断结果判断是否有血栓形成,分为血栓组和正常组,比较两组一般资料和PBMC中NF-κB mRNA相对表达量、血清IL-6水平差异。根据DVT严重程度将血栓组分为轻度组、中度组和重度组,比较三组上述各指标差异,分析上述指标和DVT严重程度的相关性。采用多因素logistic回归分析TKA术后DVT危险因素。结果:TKA术后预防性用药后21例(17.07%)患者出现DVT,血栓组BMI≥28 kg/m2、术前诊断类风湿性关节炎(RA)患者的比例均显著高于正常组(P<0.05)。血栓组PBMC中NF-κB mRNA相对表达量和血清IL-6水平均显著高于正常组,且随着DVT严重程度增加而升高,Spearman相关分析显示两者与DVT严重程度均呈正相关(P<0.05)。多因素logistic回归分析结果显示,BMI、RA、PBMC中NF-κB mRNA相对表达量和血清IL-6水平均是TKA术后DVT的独立危险因素(P<0.05)。结论:PBMC中NF-κB mRNA高表达和血清IL-6水平升高均与TKA术后DVT有关。对于肥胖、术前诊断RA患者行TKA且术后PBMC中NF-κB mRNA高表达和血清IL-6水平明显升高者应提早做好预防措施,降低DVT发生的风险。Objective:To study the relationship between nuclear factor-κB(NF-κB)mRNA expression in peripheral blood mononuclear cells(PBMC)and serum interleukin-6(IL-6)level and deep vein thrombosis(DVT)of lower limbs after knee replacement(TKA).Method:A total of 123 patients who underwent TKA in Foshan Gaoming District People’Hospital from April 2017 to March 2021 were selected as the research objects.After operation,they were divided into thrombus group and normal group according to the results of color Doppler ultrasound diagnosis.The general data,the relative expression of NF-κB mRNA in PBMC and the serum IL-6 level of two groups were compared.According to the severity of DVT,they were divided into mild group,moderate group and severe group.The differences of the above indicators among three groups were compared and the correlation between the above indicators and the severity of DVT was analyzed.Multivariate logistic regression was used to analyze the risk factors of DVT after TKA.Result:DVT occurred in 21 cases(17.07%)after preventive medication after TKA.The BMI≥28 kg/m2 and the proportion of patients diagnosed with rheumatoid arthritis(RA)before operation in thrombus group were significantly higher than those in normal group(P<0.05).The relative expression of NF-κB mRNA in PBMC and the serum IL-6 level in thrombus group were significantly higher than those in normal group,and increased with the increase of DVT severity.Spearman correlation analysis showed that both of them were positively correlated with DVT severity(P<0.05).The multivariate logistic regression analysis showed that BMI,RA,the relative expression of NF-κB mRNA in PBMC and serum IL-6 level were independent risk factors of DVT after TKA(P<0.05).Conclusion:The high expression of NF-κB mRNA in PBMC and the increase of serum IL-6 level are related to DVT after TKA.For obesity,those patients with RA diagnosed by TKA before operation,those NF-κB mRNA expression in PBMC and serum IL-6 level increased significantly after operation,should take preven

关 键 词：膝关节置换术 下肢深静脉血栓形成 核因子-ΚB 白介素-6 

分 类 号：R687.4[医药卫生—骨科学] R543.6[医药卫生—外科学]