腰椎间盘突出症术后椎间隙感染与外周血β-catenin、GSK-3β蛋白表达的相关性  

Correlation between postoperative intervertebral space infection and expressions ofβ-catenin and GSK-3βproteins in peripheral blood of lumbar disc herniation patients

作　　者：刘乃豪 梁洪瑞 宋永生 王颖男 李润 LIU Naihao;LIANG Hongrui;SONG Yongsheng;WANG Yingnan;LI Run(Harbin Orthopedics and Traumatology Hospital,Harbin,Heilongjiang 150001,China;不详)

机构地区：[1]哈尔滨市骨伤科医院外科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第一医院心内五病房,黑龙江哈尔滨150001 [3]哈尔滨市骨伤科医院手足科,黑龙江哈尔滨150001

出　　处：《中华医院感染学杂志》2025年第5期667-671,共5页Chinese Journal of Nosocomiology

基　　金：黑龙江省自然科学基金优青基金资助项目(YQ2019G003)。

摘　　要：目的分析腰椎间盘突出症(LDH)患者术后发生椎间隙感染与β-连环蛋白(β-catenin)、糖原合成酶激酶3β(GSK-3β)蛋白表达的关系。方法选取2022年1月-2024年5月于哈尔滨市骨伤科医院行手术治疗的201例LDH患者,按术后椎间隙感染情况分为感染组和未感染组,检测感染组患者病原菌构成及耐药性,并对比两组外周血Wnt、β-catenin和GSK-3β的蛋白相对表达量。结果201例行手术治疗的LDH患者术后发生椎间隙感染21例,感染率为10.45%。21例感染组患者中分离病原菌共26株,其中革兰阴性菌11株,占42.31%,革兰阳性菌15株,占57.69%。感染组手术时间(3.46±0.89)h长于未感染组(3.09±0.73)h(t=2.146,P=0.033),且感染组和未感染组外周血β-catenin、GSK-3β蛋白表达比较,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线显示,β-catenin、GSK-3β相对蛋白表达量诊断椎间隙感染的曲线下面积(AUC)分别为0.836、0.800,敏感度分别为52.40%、66.70%,特异度分别为90.56%、93.89%,临界值分别为5.65、2.15。结论LDH患者术后发生椎间隙感染风险较高,发生椎间隙感染后Wnt/β-catenin信号通路被激活,相关蛋白β-catenin和GSK-3β的表达水平升高,检测其水平可用于预警LDH患者手术后椎间隙感染发生。OBJECTIVE To analyze the relationship between the postoperative intervertebral space infection and the expressions ofβ-catenin and glycogen synthase kinase-3β(GSK-3β)in the patients with lumbar disc herniation(LDH).METHODS A total of 201 patients with LDH who received surgical procedures in Harbin Orthopedics and Traumatology Hospital from Jan.2022 to May 2024 were enrolled in the study and were divided into the infection group and the no infection group according to the status of postoperative intervertebral space infection.The distribution and drug resistance of pathogens isolated from the patients of the infection group were detected.The relative expression levels of peripheral blood Wnt,β-catenin and GSK-3βproteins were compared between the two groups.RESULTS Among the 201 patients who received surgical procedures,21 had postoperative intervertebral space infections,with the infection rate 10.45%.Totally 26 strains of pathogens were isolated from the 21 patients in the infection group,11(42.31%)of which were gram-negative bacteria,and 15(57.69%)were gram-positive bacteria.The operation duration of the infection group was(3.46±0.89)hour,longer than(3.09±0.73)hour of the no infection group(t=2.146,P=0.033).There were significant differences in the expressions of peripheral bloodβ-catenin and GSK-3βproteins between the infection group and the no infection group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the areas under the curves(AUCs)of the relative expression levels ofβ-catenin and GSK-3βwere 0.836 and 0.800,respectively;the sensitivities were 52.40%and 66.70%,respectively;the specificities were 90.56%and 93.89%,respectively;the cut-off point were 5.65 and 2.15,respectively.CONCLUSIONS The LDH patients are at high risk of postoperative intervertebral space infection,the patients with the infection show the activation of Wnt/β-catenin signaling pathways and the rise of expression levels ofβ-catenin and GSK-3βproteins.The levels of the indexes may facilitate the predic

关 键 词：腰椎间盘突出症 椎间隙感染 Β-连环蛋白 糖原合成酶激酶-3Β 术后感染 病原菌 

分 类 号：R681.53[医药卫生—骨科学]