髓核成形术后炎症因子与预后转归在不同年龄段的表达变化研究  

A Study of Changes in the Expression of Inflammatory Factors and Prognostic Regression After Myeloplasty in Different Age Groups

作　　者：殷海东 许国增[1] 贺宪[1] 王延涛[1] 林思薪 直彦亮[1] 邱太彬 YIN Haidong;XU Guozeng;HE Xian;WANG Yantao;LIN Sixin;ZHI Yanliang;QIU Taibin(Department of Spinal Minimally Invasive Surgery,Guangzhou Panyu District Hospital of Traditional Chinese Medicine,Guangzhou,Guangdong 511400,China)

机构地区：[1]广州市番禺区中医院脊柱微创专科,广东广州511400

出　　处：《中国医药指南》2025年第4期54-56,共3页Guide of China Medicine

基　　金：番禺区科技计划医疗卫生重点学科资助项目(2021-Z04-010)。

摘　　要：目的探讨不同年龄段腰椎间盘突出患者髓核成形术后炎症因子表达与预后转归的相关性。方法总结2022年1月至2023年12月在广州市番禺区中医院接受髓核成形术治疗的腰椎间盘突出患者120例,根据年龄分为青年组47例(≤44岁)、中年组44例(45~59岁)和老年组29例(≥60岁)。采用疼痛视觉模拟量表(VAS)评分和改良版MacNab标准来评价疼痛改善和临床疗效,检测血清中的白细胞介素1α(IL-1α)、白细胞介素6(IL-6)、前列腺素E_(2)(PGE_(2))、肿瘤坏死因子α(TNF-α)、金属基质蛋白酶1(MMP-1)水平,分别在术前1 d,术后1 d、7 d、1个月和3个月进行检测。结果青年组和中年组IL-1α和IL-6在术后7 d开始下降,VAS评分在术后1 d开始下降(均P<0.05),两组优良率接近。老年组各炎症因子水平在不同时间点较术前差异均无统计学意义,术后1个月、3个月VAS评分与术前对比差异无统计学意义(均P>0.05),优良率低于青年组和中年组。结论髓核成形术后IL-1α和IL-6表达水平可在一定程度上提示预后转归情况,年龄因素也会对治疗效果产生一定影响。Objective To investigate the correlation between the expression of inflammatory factors and prognostic regression after nucleoplasty in patients with lumbar disc herniation in different age groups.Methods A total of 120 patients with lumbar disc herniation who received nucleus pulpoplasty in Panyu District Hospital of Traditional Chinese Medicine,Guangzhou from January 2022 to December 2023 were divided into 47(≤44 years old)group,44(45-59 years old)group and 29(≥60 years old)group according to age.Visual Analogue Scale(VAS)scores and modified MacNab criteria were used to evaluate pain improvement and clinical efficacy.Serum levels of interleukin-1α(IL-1α),interleukin-6(IL-6),prostaglandin E_(2)(PGE_(2)),tumor necrosis factor-α(TNF-α)and metal matrix degrading enzyme-1(MMP-1)at 1 day before surgery,1 day,7 days,1 month and 3 months after surgery,respectively.Results In the young and middle-aged groups,IL-1αand IL-6 began to decrease at 7 days postoperatively,and VAS scores began to decrease at 1 days postoperatively(both P<0.05),and the excellent rates were close to each other in the two groups.In the elderly group,there was no statistically significant difference in the levels of inflammatory factors at different time points compared with the preoperative period,and the differences in the VAS scores at 1 and 3 months postoperatively were not statistically significant compared with the preoperative period(both P>0.05),and the good rate was lower than that in the young and middle-aged groups.Conclusions The level of IL-1αand IL-6 expression after nucleoplasty maybe an indicative of prognostic regression,and the age factor possibly have an impact on therapeutic effect.

关 键 词：髓核成形术 炎症因子 年龄 预后转归 

分 类 号：R687.3[医药卫生—骨科学]