激光椎间盘减压术对盘源性腰痛患者血清中6-keto-PGE1α水平的影响

The Influence of Percutaneous Laser Disc Decompression on The Level of Serum 6-keto-PGE1α of Discogenic Back Pain Patients

目的观察经皮激光椎间盘减压术(percutaneous laser disc decompression,PLDD)对椎间盘源性腰痛(discogenic low back pain,DLBP)患者血清中6-酮-前列腺素E1α(6-keto-PGE1α)水平的影响,为临床应用、推广这一治疗方法提供理论依据。方法 30例DLBP患者分为治疗前(A)及治疗后(B)两组,进行术前及术后1周血清中6-ke-to-PGE1α水平的检测,对30例健康者(C组)也进行其检测。采用疼痛视觉模拟评分(visual analog scale,VAS)作为腰痛缓解疗效评价指标,并对手术前后评分进行统计学分析。采用中华医学会脊柱学组腰背痛手术评定标准作为术后功能评定标准。结果 A组(54.745 0±12.663)pg/mL明显高于B组(47.307 5±5.316)pg/mL及C组(45.338 0±7.909)pg/mL,差异具有统计学意义(P<0.05)。对A、B两组资料进行配对t检验及双尾检验,差异具有统计学意义。VAS评分B组(1.0±1.8)分比A组(7.7±1.0)分明显下降,有非常显著的差异(P<0.01),功能评定优21例,良7例,可1例,差1例,优良率93.3%。结论前列腺素E2与PLDD治疗DLBP的机制密切相关。

Objective To study the influence of percutaneous laser disc decompression on the level of serum 6-keto-PGE1α of discogenic back pain Patients,to offer a theoretical basis of clinical application and promotion.Methods 30 cases of DLBP were divided into 2 groups：pretreatment and post-treament,serum 6-keto-PGE1αconcentration were measured before therapy and after therapy 1 week.30 volunteer peoples who were health blood donor as the control group and measured serum 6-keto-PGE1α.The visual analogue scale（VAS） and the operation evaluation criteria of lumbago and backache of Chinese Medical Association Spine Group was taken to value the therapeutic effect.Results the concentration of serum 6-keto-PGE1αin Group A（54.745 0±12.663） pg/mL is much higher than in group B（47.307 5±5.316） pg/mL and C（45.338 0±7.909） pg/mL,the difference is significant（P〈0.05）.By pairedT analysis,the difference between group A,B（before therapy and after therapy） was significant.The VAS score in group B（1.0±1.8） was much lower than that of group A,there were significant differences（P〈0.01） between them.The assessment of function was excellent in 21cases,good in 7 cases,fair in 1 cases,bad in 1 cases.The excellent and good rate was 93.3%.Conclusion PGE2 has been proved high compact with the mechanism of PLDD in treatment of DLBP.