腰椎管狭窄症患者血清IL-1α、CRP、TNF-α表达及其与Oswestry功能障碍指数的关系  

Serum in patients with degenerative lumbar spinal stenosis IL-1α,CRP,TNF-αexpression and its relationship with Oswestry dysfunction index

作　　者：陈盈君 叶林辉 包先国 陆海涛 程庆华 CHEN Ying-jun;YE Lin-hui;BAO Xian-guo(Department of Orthopedics,Nanjing Lishui District People's Hospital/Lishui Branch of Affiliated Hospital of Southeast University,Nanjing Jiangsu 211200,China)

机构地区：[1]南京市溧水区人民医院/东南大学附属中大医院溧水分院骨科,江苏南京211200

出　　处：《临床和实验医学杂志》2023年第5期510-513,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省青年科学基金项目(编号:BK20180370);江苏大学临床医学科技发展基金项目(编号:JLY20180036)。

摘　　要：目的探讨退行性腰椎管狭窄症(DLSS)患者血清白细胞介素-1α(IL-1α)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)表达及其与Oswestry功能障碍指数(ODI)的关系。方法回顾性选取2019年3月至2022年3月南京市溧水区人民医院收治的DLSS患者82例作为观察组,另选取同期体检健康者80名作为对照组。并依据ODI评分将观察组患者分为轻中度功能障碍组(n=48)和重度功能障碍组(n=34)。测量所有研究对象总多裂肌横截面积(TCSA)、总无脂肪多裂肌横截面积(TFCSA)和计算TFCSA/TCSA比值,并检测血清IL-1α、CRP、TNF-α、皮质醇、促肾上腺皮质激素(ACTH)水平。比较两组间、不同严重程度功能障碍患者间的TCSA、TFCSA、TFCSA/TCSA值及血清IL-1α、CRP、TNF-α、皮质醇、ACTH水平;以Pearson系数分析血清L-1α、CRP、TNF-α水平与ODI的相关性。结果观察组TFCSA、TFCSA/TCSA为(1.04±0.22)cm^(2)、0.68±0.14,均低于对照组[(1.29±0.33)cm^(2)、0.82±0.22],差异均有统计学意义(P<0.05);两组TCSA比较差异无统计学意义(P>0.05)。观察组血清IL-1α、CRP、TNF-α、皮质醇、ACTH水平为(87.76±16.44)ng/L、(11.83±1.24)mg/L、(52.79±2.34)pg/mL、(40.01±1.54)mmol/L、(734.76±25.87)pg/mL,均显著高于对照组[(59.87±18.54)ng/L、(3.66±0.37)mg/L、(9.16±1.37)pg/mL、(12.42±2.14)mmol/L、(234.05±22.68)pg/mL],差异均有统计学意义(P<0.05)。轻中度功能障碍组TFCSA、TFCSA/TCSA均大于重度功能障碍组,差异均有统计学意义(P<0.05);两组TCSA比较差异无统计学意义(P>0.05)。轻中度功能障碍组血清IL-1α、CRP、TNF-α、皮质醇、ACTH水平均显著低于重度功能障碍组,差异均有统计学意义(P<0.05)。经相关性分析,血清IL-1α、CRP、TNF-α水平与ODI均呈正相关关系(r=0.524、0.516、0.537,P<0.05)。结论血清IL-1α、CRP、TNF-α水平在DLSS不同严重程度功能障碍患者和健康者中存在显著差异,血清IL-1α、CRP、TNF-α水平与ODI存在显著相关性,�Objective To investigate the expression of serum interleukin-1α(IL-1α),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and its relationship with Oswestry dysfunction index(ODI)in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 82 cases of degenerative DLSS patients admitted to Nanjing Lishui District People's Hospital from March 2019 to March 2022 were selected as the observation group,and 80 healthy persons in the same period were selected as the control group.The patients in the observation group were divided into mild to moderate dysfunction group(n=48)and severe dysfunction group(n=34)according to the ODI score.Total multifidus cross-sectional area(TCSA),total fat free multifidus cross-sectional area(TFCSA),TFCSA/TCSA ratio and serum were measured in all subjects IL-1α,CRP,TNF-α,cortisol and adrenocorticotropic hormone(ACTH)levels.The values of TCSA,TFCSA,TFCSA/TCSA and the levels of IL-1α,CRP,TNF-α,cortisol and ACTH in serum between the two groups and among patients with dysfunction of different severity were compared;the correlation between serum IL-1α,CRP,TNF-αlevels and ODI was analyzed by Person coefficient.Results TFCSA and TFCSA/TCSA in the observation group were(1.04±0.22)cm^(2),0.68±0.14,which were lower than those in the control group[(1.29±0.33)cm^(2),0.82±0.22],the differences were statistically significant(P<0.05);there was no difference in TCSA between the two groups(P>0.05).The levels of serum IL-1α,CRP,TNF-α,cortisol and ACTH in observation group were(87.76±16.44)ng/L,(11.83±1.24)mg/L,(52.79±2.34)pg/mL,(40.01±1.54)mmol/L,(734.76±25.87)pg/mL,which were significantly higher than those in the control group[(59.87±18.54)ng/L,(3.66±0.37)mg/L,(9.16±1.37)pg/mL,(12.42±2.14)mmol/L,(234.05±22.68)pg/mL],the differences were statistically significant(P<0.05).TFCSA and TFCSA/TCSA in mild and moderate dysfunction group were higher than those in severe dysfunction group,the differences were statistically significant(P<0.05);there was no difference in

关 键 词：退行性腰椎管狭窄症 白细胞介素-1Α C反应蛋白 肿瘤坏死因子-α OSWESTRY功能障碍指数 

分 类 号：R687.3[医药卫生—骨科学]