急性脊髓损伤患者早期血清标志物与AISA分级的相关性  

Correlation between early serum markers and AISA grading in patients with acute spinal cord injury

作　　者：王月光 穆晓红[2] 蒋昇源 邓博文 康喜梅 苏建光 Wang Yueguang;Mu Xiaohong;Jiang Shengyuan;Deng Bowen;Kang Ximei;Su Jianguang(Chinese Medicine Hospital of Puyang,Puyang 457000,Henan Province,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]濮阳市中医医院,河南省濮阳市457000 [2]北京中医药大学东直门医院,北京市100700

出　　处：《中国组织工程研究》2024年第34期5494-5499,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前临床针对急性脊髓损伤严重程度的评估方法存在一定局限性,亟需一种快速、精准的评估手段。目的:分析急性脊髓损伤患者血清内相关氧化应激、神经损伤指标表达量与疾病严重程度的相关性。方法:选择2020年8月至2022年5月濮阳市中医医院收治的患者65例,其中急性脊髓损伤患者32例(试验组),单纯脊柱骨折患者33例(对照组),入院8 h内,评估患者美国脊髓损伤协会(ASIA)残损分级及神经功能评分,采集静脉血样本来检测血清中超氧化物歧化酶、丙二醛、谷胱甘肽、一氧化氮、神经胶质纤维酸性蛋白和神经元特异性烯醇化酶的水平,分析上述血清指标与ASIA残损分级、神经功能评分的相关性。结果与结论:(1)与对照组相比,试验组患者血清超氧化物歧化酶、谷胱甘肽水平降低(P <0.001),丙二醛、一氧化氮、神经胶质纤维酸性蛋白和神经元特异性烯醇化酶水平升高(P <0.01);(2)Pearson或Spearman相关分析显示,试验组患者血清中超氧化物歧化酶、谷胱甘肽水平与AISA残损分级呈正相关(r=0.862 4,0.849 3,P <0.01),丙二醛、神经胶质纤维酸性蛋白、神经元特异性烯醇化酶水平与AISA残损分级呈负相关(r=-0.866 1,-0.638 1,-0.746 6,P <0.001),一氧化氮与AISA残损分级无明显相关性(r=-0.177 5,P> 0.05);试验组患者血清中谷胱甘肽水平与AISA感觉功能评分呈正相关(r=0.569 9,P <0.001),丙二醛、神经胶质纤维酸性蛋白、神经元特异性烯醇化酶与AISA感觉功能评分呈负相关(r=-0.574 1,-0.376 2,-0.708 6,P <0.05),超氧化物歧化酶、一氧化氮水平与AISA感觉功能评分无明显相关性(r=0.230 8,-0.099 2,P> 0.05);试验组患者血清超氧化物歧化酶、谷胱甘肽水平与ASIA运动功能评分呈正相关(r=0.380,0.524 7,P <0.05),丙二醛、神经胶质纤维酸性蛋白、神经元特异性烯醇化酶水平与ASIA运动功能评分呈负相关(r=-0.577 9,-0.452 2,-0.662 8,P <0.05),�BACKGROUND:At present,there are some limitations in evaluating the severity of acute spinal cord injury,and a rapid and accurate evaluation method is urgently needed.OBJECTIVE:To analyze the correlation between the expression levels of serum oxidative stress and nerve injury indexes and the severity of the disease in patients with acute spinal cord injury.METHODS:A total of 65 patients were included in the study from August 2020 to May 2022,including 32 patients in the experimental group(acute spinal cord injury)and 33 patients in the control group(simple spinal fracture).American Spinal Injury Association(ASIA)Impairment Scale and neurological function score were evaluated within 8 hours of admission.Meanwhile,serum levels of superoxide dismutase,malondialdehyde,glutathione,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase were detected and compared between the two groups.The correlation between the expression levels of the above serological indicators in serum and ASIA impairment grade and AISA neural function score was analyzed.RESULTS AND CONCLUSION:The average serum levels of superoxide dismutase and glutathione in the experimental group were significantly lower than those of the control group(P<0.001),while the average serum levels of malondialdehyde,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase in the experimental group were higher than those of the control group(P<0.01).The serum levels of superoxide dismutase and glutathione in the experimental group were positively correlated with the damage grade of AISA(r=0.8624,0.8493,P<0.01),while the serum levels of malondialdehyde,nitric oxide,glial fibrillary acidic protein and neuron-specific enolase were negatively correlated with the damage grade of AISA(r=-0.8661,-0.6381,-0.7466,P<0.001),and the serum level of nitric oxide was not significantly correlated with the damage grade of AISA(r=-0.1775,P>0.05).The serum level of glutathione in the experimental group was positively correlated with AISA sensory function

关 键 词：急性脊髓损伤 AISA分级 标志物 氧化应激 神经损伤 

分 类 号：R446[医药卫生—诊断学] R319[医药卫生—临床医学] R741.04