腰椎椎管狭窄症黄韧带组织中高迁移率族蛋白B1的表达及其与术后疾病转归的相关性  

Expression of high mobility group box-1 in ligamentum flavum tissue of lumbar spinal stenosis and its correlation with postoperative disease outcome

作　　者：王玉[1] 王晓红 郭敬然[1] 李珊[3] 原野[1] 赵静 Wang Yu;Wang Xiaohong;Guo Jingran;Li Shan;Yuan Ye;Zhao Jing(First Department of Spinal Surgery,Second Hospital of Tangshan City,Tangshan 063000,Hebei,China;Department of Nursing,Second Hospital of Tangshan City,Tangshan 063000,Hebei,China;Department of Nosocomial Infection,Second Hospital of Tangshan City,Tangshan 063000,Hebei,China;Department of Pathology,School of Basic Medicine,North China University of Technology,Tangshan 063399,Hebei,China)

机构地区：[1]唐山市第二医院脊柱一科,唐山063000 [2]唐山市第二医院护理部,唐山063000 [3]唐山市第二医院医院感染科,唐山063000 [4]华北理工大学基础医学院病理系,唐山063399

出　　处：《脊柱外科杂志》2024年第3期164-169,共6页Journal of Spinal Surgery

基　　金：河北省卫生健康委员会医学科学研究课题计划项目(20231734)。

摘　　要：目的探讨腰椎椎管狭窄症(LSS)患者黄韧带组织中高迁移率族蛋白B1(HMGB1)表达水平与术后疾病转归的相关性。方法选取2021年2月—2022年2月唐山市第二医院收治的232例接受经椎间孔入路腰椎椎间融合术(TLIF)治疗的LSS患者进行前瞻性队列研究,收集术中黄韧带组织并测定其中HMGB1表达水平,根据HMGB1水平四分位数将患者分为4组,每组58例。术后1年采用MacNab标准评估疾病转归情况,分析黄韧带组织中HMGB1表达水平对LSS患者术后1年疾病转归的影响与预测价值。结果所有患者术后1年疗效优良率为78.88%。年龄、是否合并糖尿病、是否合并骨质疏松症、不同Schizas分型及不同黄韧带组织中HMGB1表达水平是患者术后疗效的影响因素。经Kendall’s tau-b相关性检验发现,黄韧带组织中HMGB1表达水平与Schizas分型呈正相关(r=0.340,P<0.001),与术后1年MacNab标准分级呈负相关(r=-0.316,P<0.001)。经分层回归分析发现,校正了上述因素后,黄韧带组织中HMGB1高表达是LSS患者术后转归不良的独立危险因子。绘制受试者工作特征(ROC)曲线与决策曲线发现,黄韧带组织中HMGB1表达水平对LSS患者术后疾病转归具有一定预测价值。结论黄韧带组织中HMGB1表达水平与LSS患者Schizas分型有关,对患者术后疾病转归有一定预测价值。Objective To investigate the correlation between the expression level of high mobility group box-1(HMGB1)in ligamentum flavum tissue in patients with lumbar spinal stenosis(LSS)and postoperative disease outcome.Methods From February 2021 to February 2022,a prospective cohort study was conducted in 232 LSS patients treated by transforaminal lumbar interbody fusion(TLIF)in Second Hospital of Tangshan City.Ligamentum flameum tissues were collected intraoperatively and HMGB1 expression levels were measured.The patients were divided into 4 groups according to the quartile of HMGB1 level,58 cases in each group.MacNab criteria was used to evaluate the disease outcome at postoperative 1 year,and the effect and predictive value of HMGB1 expression level in ligamentum flavum tissue on the disease outcome of LSS patients were analyzed.Results The 1-year postoperative excellent and good efficacy rate of all the patients was 78.88%.Age,with diabetes mellitus or not,with osteoporosis or not,different Schizas classification and HMGB1 expression level in different ligamentum flavum tissues were the factors influencing the therapeutic effect.Kendall's tau-b correlation test showed that the expression level of HMGB1 in ligamentum flavum tissue was positively correlated with Schizas classification(r=0.340,P<0.001),and negatively correlated with MacNab criteria at postoperative 1 year(r=-0.316,P<0.001).Hierarchical regression analysis showed that after correcting the above factors,it was found that high expression of HMGB1 in ligamentum flavum tissue was an independent risk factor for poor postoperative outcomes in LSS patients.Receiver operating characteristic(ROC)curve and decision curve showed that the expression level of HMGB1 in ligamentum flavum tissue had a certain predictive value for the prognosis of LSS patients.Conclusion The expression level of HMGB1 in ligamentum flavum tissue is related to the Schizas classification of LSS patients,which has a certain predictive value for the disease outcome.

关 键 词：腰椎 椎管狭窄 脊柱融合术 预后 因素分析 统计学 高迁移率族蛋白B1 

分 类 号：R681.533[医药卫生—骨科学]