PTED治疗对腰椎间盘突出症IL-6、HMGB-1、IL-17水平的影响

Effect of PTED treatment on IL-6,HMGB-1 and IL-17 levels in lumbar disc herniation

目的探讨经皮椎间孔镜下椎间盘切除术(PTED)治疗对腰椎间盘突出症白介素-6(IL-6)、白介素-17(IL-17)和高迁移率族蛋白-1(HMGB-1)水平的影响。方法选取2019年4月至2022年8月保定市第一中心医院收治的122例腰椎间盘突出症患者为研究对象,根据不同治疗方案分为TLIF组[n=58,经椎间孔腰椎融合术(TLIF)治疗]和PTED组(n=64,PTED治疗),比较两组IL-6、HMGB-1、IL-17水平、分析PTED组不同临床特征与病理特征的IL-6、HMGB-1、IL-17水平、采用多元Logistic回归分析影响PTED组IL-6、HMGB-1、IL-17水平的危险因素,比较两组临床疗效及并发症情况。结果PTED组总有效率(98.44%)高于TLIF组(87.93%),差异有统计学意义(P<0.05);PTED组IL-6、IL-17、HMGB-1水平均低于TLIF组,差异有统计学意义(P<0.05);PTED组不同年龄、有无糖尿病、手术时间长短、是否吸烟、是否营养不良和是否免疫功能低下之间IL-6、IL-17、HMGB-1水平比较,差异有统计学意义(P<0.05);不同性别、不同BMI、术中出血量多少、有无使用内固定之间IL-6、IL-17、HMGB-1水平比较,差异无统计学意义(P>0.05);多元Logistic回归分析显示,年龄>60岁、手术时间>3h、营养不良、糖尿病、免疫功能低下、吸烟为影响PTED组IL-6、IL-17、HMGB-1水平的危险因素(P<0.05);PTED组并发症总发生率低于TLIF组,差异有统计学意义(P<0.05)。结论PTED治疗能明显降低腰椎间盘突出症患者IL-6、HMGB-1和IL-17水平,且手术疗效确切;而年龄、手术时间、营养不良、糖尿病、免疫功能低下、吸烟等是影响PTED治疗对腰椎间盘突出症IL-6、HMGB-1、IL-17水平的危险因素。

Objective To explore the effects of percutaneous transforaminal endoscopic discectomy(PTED)treatment on interleukin-6(IL-6),interleukin-17(IL-17)and high mobility group protein-1(HMGB-1)levels in lumbar disc herniation.Methods 122 patients with lumbar disc herniation admitted to the First Central Hospital of Baoding City from April 2019 to August 2022 were selected as the research subjects,according to the different treatment plan,they were divided into the TLIF group(n=58,Transforaminal lumbar interbody fusion(TLIF)treatment)and the PTED group(n=64,PTED treatment),IL-6,HMGB-1,and IL-17 levels between the two groups were compared,IL-6,HMGB-1,and IL-17 levels in the PTED group with different clinical and pathological characteristics were analyzed,and the multiple logistic regression analysis was used to analyze the risk factors affecting IL-6,HMGB-1,and IL-17 levels in the PTED group,the clinical efficacy and complications of the two groups were compared.Results The total effective rate of the PTED group(98.44%)was higher than that of the TLIF group(87.93%),and the difference was statistically significant(P<0.05).The levels of IL-6,IL-17 and HMGB-1 in the PTED group were lower than those in the TLIF group,and the difference was statistically significant(P<0.05).There were statistically significant differences between the levels of IL-6,IL-17,and HMGB-1 in different ages,presence of diabetes,the length of operation time,smoking status,malnutrition,and low immune function subgroups of the PTED group(P<0.05).There was no statistically significant difference in the levels of IL-6,IL-17,and HMGB-1 between different genders,different BMIs,intraoperative blood loss,and the usage of internal fixation subgroups(P>0.05).Multiple logistic regression analysis showed that,age>60 years,operation time>3 hours,malnutrition,diabetes,low immune function,and smoking were risk factors affecting IL-6,IL-17,and HMGB-1 levels in the PTED group(P<0.05).The total incidence of complications in the PTED group was lower than that of the TLIF group,and the difference was statistically significant(P<0.05).Conclusion PTED treatment can significantly reduce the levels of IL-6,HMGB-1 and IL-17 in patients with lumbar disc herniation,and the surgical effect is accurate;however,age,operation time,malnutrition,diabetes,low immune function,and smoking are factors that affect IL-6,HMGB-1,and IL-17 levels in lumbar disc herniation by PTED treatment.