[1]邵海龙,穆佐洲.机体炎症水平和氧化应激水平与腰椎间盘突出症椎间孔镜术后残留疼痛相关性研究[J].陕西医学杂志,2022,51(10):1274-1277,1281.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.024]
　SHAO Hailong,MU Zuozhou.Correlation between inflammation level,oxidative stress level and residual pain after transforaminal endoscopic surgery for lumbar disc herniation[J].,2022,51(10):1274-1277,1281.[doi:DOI:10.3969/j.issn.1000-7377.2022.10.024]
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机体炎症水平和氧化应激水平与腰椎间盘突出症椎间孔镜术后残留疼痛相关性研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年10期
页码:
1274-1277,1281
栏目:
临床研究
出版日期:
2022-10-05

文章信息/Info

Title:
Correlation between inflammation level,oxidative stress level and residual pain after transforaminal endoscopic surgery for lumbar disc herniation
作者:
邵海龙; 穆佐洲
(陕西省第四人民医院骨科,陕西 西安 710043)
Author(s):
SHAO Hailong; MU Zuozhou
(Department of Orthopedics,the Fourth People's Hospital of Shaanxi Province,Xi'an 710043,China)
关键词:
腰椎间盘突出症;  椎间孔镜;  残留疼痛;  炎症反应;  氧化应激;  相关性
Keywords:
Lumbar disc herniation;  Transforaminal endoscopy;  Residual pain;  Inflammatory reaction;  Oxidative stress;  Correlation
分类号:
R 681.5
DOI:
DOI:10.3969/j.issn.1000-7377.2022.10.024
文献标志码:
A
摘要:
目的:探究机体炎症水平及氧化应激水平与腰椎间盘突出症(LDH)椎间孔镜术后残留疼痛的相关性。方法:收集预接受椎间孔镜手术治疗的77例LDH为研究对象,患者均顺利完成手术治疗。统计患者手术情况和术后随访6个月内残留疼痛情况,对比患者术前和术后4周疼痛情况、腰椎功能、机体炎症和氧化应激水平。分析术后4周血清炎症和氧化应激水平与残留疼痛的相关性。结果: 纳入者手术穿刺时间27～63(43.86±8.61)min,镜下操作时间23～57(40.74±8.19)min,手术时间57～143(84.60±11.81)min; 术中出血量23～202 ml,20.78%术中接受纤维环修复。与术前比,患者术后4周时视觉模拟评分法(VAS)、腰椎Oswetry功能障碍指数(ODI)评分和血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8、血清活性氧(ROS)、丙二醛(MDA)水平均明显下降,血清总抗氧化能力(T-AOC)水平明显升高(均P<0.05)。术后随访显示,28.57%患者术后出现残留疼痛。观察组血清TNF-α、IL-6、IL-8、ROS、MDA水平明显大于对照组,是术后残留疼痛发生的危险因素(均P<0.05),血清T-AOC水平低于对照组,是术后残留疼痛发生的保护性因素(P<0.05); ROC曲线显示,血清TNF-α、IL-6、IL-8、ROS、T-AOC、MDA均在预测患者术后残留疼痛方面具有一定价值(AUC=0.752～0.883)。结论: 椎间孔镜创伤小,能有效降低LDH患者术后炎症及氧化应激反应,而患者术后炎症及氧化应激反应水平与残留疼痛密切相关,对残留疼痛具有一定预测价值。
Abstract:
Objective:To explore the correlation between the inflammation level,oxidative stress level and residual pain after transforaminal endoscopic surgery for lumbar disc herniation(LDH).Methods:A total of 77 cases of LDH who had received transforaminal endoscopic surgery were collected as the research object,and all the patients successfully completed the surgical treatment.The operative conditions and postoperative residual pain within 6 months were counted,and the pain,lumbar function,body inflammation and oxidative stress levels before surgery and 4 weeks after surgery were compared.The correlation between serum levels of inflammation,oxidative stress and residual pain 4 weeks after surgery was analyzed.Results:The operation puncture time was 27 to 63(43.86±8.61)min,the operation time under microscope was 23 to 57(40.74±8.19)min,and the operation time was 57 to 143(84.60±11.81)min,and the intraoperative blood loss was 23 to 202 [44(32,70.5)] ml,and 20.78% of them were repaired with fibrous ring.Compared with preoperative,the scores of VAS,ODI and the levels of serum TNF-α,IL-6,IL-8,ROS and MDA decreased significantly,and serum T-AOC level increased significantly at the 4th week after operation(all P<0.05).Postoperative follow-up showed that 28.57% patients had residual pain after operation.The levels of serum TNF-α,IL-6,IL-8,ROS and MDA in the observation group were significantly higher than those in the control group,which were risk factors for postoperative residual pain(all P<0.05),while the level of serum T-AOC was lower than that in the control group,which was protective factor for postoperative residual pain(all P<0.05).ROC curve showed that serum TNF-α,IL-6,IL-8,ROS,T-AOC and MDA had a certain value in predicting postoperative residual pain(AUC:0.752 to 0.883).Conclusion:The transforaminal endoscopic surgery is minimally invasive and can effectively reduce postoperative inflammation and oxidative stress in LDH patients.The levels of postoperative inflammation and oxidative stress in patients is closely related to residual pain,which has a certain predictive value for residual pain.

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备注/Memo

备注/Memo:
基金项目:白求恩公益基金资助项目(BK-JS2017003)
更新日期/Last Update: 2022-10-07