血清MMP-2、TNF-α及IL-17在脊柱结核患者预后中的价值研究

Study on the prognostic value of serum MMP-2,TNF-α and IL-17 in patients with spinal tuberculosis

目的检测MMP-2、TNF-α及IL-17在脊柱结核患者血清中的水平,并以探讨其与患者预后的关系。方法选取2016年7月~2018年7月在本院确诊的脊柱结核患者63例,作为观察组;选取同期健康体检者36例为对照组。分别抽取两组患者术前、术后的清晨空腹静脉血,采用酶联免疫吸附法检测血清MMP-2、TNF-α及IL-17水平,用改良巴氏指数(Modified Barthel Index,MBI)评估脊柱结核患者预后情况。结果观察组患者术前的血清MMP-2、TNF-α及IL-17水平均高于对照组(P<0.05),差异有统计学意义。观察组中,手术预后良好组患者的MMP-2、TNF-α及IL-17水平均显著低于预后不良组(P<0.05),差异有统计学意义。相关性分析显示,MBI与TNF-α及IL-17水平呈负相关(P<0.05),差异有统计学意义;MBI与MMP-2水平无明显相关性(P>0.05)。ROC曲线显示,血清中TNF-α及IL-17水平较高与不良预后密切相关。结论脊柱结核患者的血清MMP-2、TNF-α及IL-17水平明显升高,TNF-α及IL-17与手术预后之间有明显的负相关性。

Objective The serum levels of MMP-2,TNF-α and IL-17 in patients with spinal tuberculosis were measured to explore the relationship between MMP-2,TNF-α,IL-17 and prognosis.Methods From July 2016 to July 2018,63 cases with spinal tuberculosis diagnosed in our hospital were selected as the study group,and 36 healthy people during the same period were selected as the control group.Fasting venous blood samples were taken from the control group and the observation group in the morning before and after operation.Serum levels of MMP-2,TNF-α and IL-17 were detected by ELISA.The prognosis of spinal tuberculosis patients was evaluated by modified Barthel index(MBI).Results The levels of serum MMP-2,TNF-α and IL-17 in the observation group were higher than those in the control group(P<0.05),and the differences were statistically significant.The levels of MMP-2,TNF-α and IL-17 in patients with good prognosis in the observation group were significantly lower than those in patients with poor prognosis(P<0.05).The correlation analysis showed that MBI was negatively correlated with TNF-α and IL-17 levels(P<0.05),and there was significant difference between MBI and MMP-2 levels(P>0.05).ROC curve showed that high levels of serum TNF-α and IL-17 were closely related to adverse prognosis.Conclusion Serum levels of MMP-2,TNF-α and IL-17 are significantly increased in patients with spinal tuberculosis,and there is significant positive correlation between TNF-α,IL-17 levels and surgical prognosis.