血清SIRT1、TGF-β1表达与退行性腰椎管狭窄症患者功能障碍指数及疼痛评分的相关性分析  

Correlation analysis of serum SIRT1 and TGF-β1 expression with functional dysfunction index and pain score in patients with lumbar spinal stenosis

作　　者：冯海涛 田有勇 赵敦 郭程亮 Feng Haitao;Tian Youyong;Zhao Dun;Guo Chengliang(Department of Trauma and Spine,Shanxi Fenyang Hospital,Shanxi Province,Fenyang 032200,China)

机构地区：[1]山西省汾阳医院创伤与脊柱科,032200

出　　处：《疑难病杂志》2024年第4期446-450,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：国家卫生健康委“十四五”规划全国重点课题项目(YGFE9889)。

摘　　要：目的分析血清沉默信息调节因子(SIRT1)、转化生长因子β1蛋白(TGF-β1)表达与退行性腰椎管狭窄症(DLSS)患者功能障碍指数及疼痛评分的相关性。方法选取2020年10月—2023年10月山西省汾阳医院创伤与脊柱科收治的DLSS患者86例作为DLSS组,依据Oswestry腰痛功能障碍指数(ODI)将患者分为轻中度功能障碍亚组(n=50)及重度功能障碍亚组(n=36);同期医院健康体检者85例作为健康对照组。收集2组临床资料,测量所有受检者总无脂肪多裂肌横截面积(TFCSA)、总多裂肌横截面积(TCSA),并计算TFCSA/TCSA比值;采用酶联免疫吸附法(ELISA)检测受检者血清SIRT1、TGF-β1、皮质醇、促肾上腺皮质激素(ACTH)水平;采用ODI评估受检者腰痛功能障碍;采用视觉模拟疼痛评分(VAS)评估受检者疼痛程度;Spearman法相关性分析血清SIRT1、TGF-β1水平与ODI指数及VAS评分的相关性;多因素Logistic回归分析DLSS发生的影响因素。结果DLSS组患者TFCSA、TFCSA/TCSA及血清SIRT1、TGF-β1水平显著低于健康对照组(t/P=8.696/<0.001、6.669/<0.001、38.323/<0.001、22.313/<0.001),皮质醇、ACTH、ODI指数、VAS评分均高于健康对照组(t/P=57.280/<0.001、58.495/<0.001、48.583/<0.001、53.355/<0.001);与轻中度功能障碍亚组比较,重度功能障碍亚组血清SIRT1、TGF-β1、TFCSA、TFCSA/TCSA水平降低(t/P=13.834/<0.001、4.684/<0.001、3.520/0.001、5.418/<0.001),皮质醇、ACTH、ODI指数、VAS评分升高(t/P=6.168/<0.001、2.355/0.021、15.784/<0.001、11.004/<0.001);相关性分析显示,血清SIRT1、TGF-β1水平与ODI指数及VAS评分呈负相关(r=-0.534、-0.577,-0.602、-0.556,P均<0.001);血清SIRT1高、TGF-β1高水平是DLSS发生的保护因素[OR(95%CI)=0.687(0.491~0.961),0.547(0.401~0.746)],皮质醇高、ACTH高、ODI指数高、VAS评分高是DLSS发生的危险因素[OR(95%CI)=2.468(1.200~5.077)、2.673(1.162~6.148)、3.345(1.165~9.602)、3.123(1.457~6.694)]。结论DLSS患者血清SIRT1、TGF-β1水平降�Objective To analyze the correlation between the expression of serum silence-information regulatory factor(SIRT1),transforming growth factorβ1 protein(TGF-β1)and dysfunction index and pain score in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 86 DLSS patients admitted to the Trauma and Spinal Department of Fenyang Hospital in Shanxi Province from October 2020 to October 2023 were selected as the DLSS group.According to the Oswestry Low Back Pain Dysfunction Index(ODI),patients were divided into mild to moderate dysfunction subgroup(n=50)and severe dysfunction subgroup(n=36).In the same period,85 healthy subjects in hospital were used as healthy control group.The clinical data of 2 groups were collected,and the total adipose multifidus cross-sectional area(TFCSA)and total multifidus cross-sectional area(TCSA)of all subjects were measured,and the ratio of TFCSA/TCSA was calculated.Serum levels of SIRT1,TGF-β1,cortisol and adrenocorticotropin(ACTH)were detected by enzyme-linked immunosorbent assay(ELISA).Low back pain dysfunction was assessed by ODI.Visual analogue pain scale(VAS)was used to evaluate the pain degree of the subjects.Spearman method was used to analyze the correlation between serum SIRT1,TGF-β1 level and ODI index and VAS score.The influencing factors of DLSS were analyzed by Logistic regression.Results The levels of TFCSA,TFCSA/TCSA and serum SIRT1,TGF-β1 in DLSS group were lower than those in healthy control group(t/P=8.696/<0.001,6.669/<0.001,38.323/<0.001,22.313/<0.001).Cortisol,ACTH,ODI index and VAS scores were higher than those of healthy control group(t/P=57.280/<0.001,58.495/<0.001,48.583/<0.001,53.355/<0.001).Serum levels of SIRT1,TGF-β1,TFCSA and TFCSA/TCSA were decreased in the severe dysfunction subgroup compared with the mild to moderate dysfunction subgroup(t/P=13.834/<0.001,4.684/<0.001,3.520/0.001,5.418/<0.001).Cortisol,ACTH,ODI and VAS scores were increased(t/P=6.168/<0.001,2.355/0.021,15.784/<0.001,11.004/<0.001).Correlation analysis showed that s

关 键 词：腰椎管狭窄症 退行性 沉默信息调节因子 转化生长因子β1蛋白 功能障碍指数 疼痛评分 

分 类 号：R681.5[医药卫生—骨科学]