IL-1基因多态性与腰椎间盘突出症伴坐骨神经痛发生风险的关系

Association between interleukin-1 gene polymorphism and the risk of lumbar disc herniation with neuralgia

目的探讨白细胞介素-1(interleukin-1,IL-1)基因多态性与腰椎间盘突出症伴坐骨神经痛发生风险的关系。方法选取2016年5月-2018年1月期间于本院治疗的腰椎间盘突出症患者96例,于纳入研究时根据等位基因IL-1A与IL-1RN基因将患者分为:(1)IL-1A C/C和IL-1RN G/G组(n=20);(2)IL-1A*/T或IL-1RN*/A组(n=53);(3)IL-1A*/T和IL-1RN*/A组(n=23)。根据IL-1B与IL-1RN基因,将患者分为:(1)IL-1B C/C和IL-1RN G/G组(n=9);(2)IL-1B*/T或IL-1RN*/A组(n=50);(3)IL-1B*/T和IL-1RN*/A组(n=37),出院6个月和12个月后对所有患者进行临床检查,采用VAS评分评估疼痛程度,ODI评分评估患者生活质量,应用PCR技术对IL-1A C/T、IL-1B T/C和IL-1RN G/A三个位点进行单核苷酸多态性检测,分析其与腰椎间盘突出症伴坐骨神经痛患者VAS评分与ODI评分的关系。结果IL-1A与IL-1RN基因型组合不同等位基因患者的VAS评分与ODI评分差异无统计学意义(P=0.175;P=0.055)。IL-1B与IL-1RN基因型组合,同时携带IL-1B T等位基因T与IL-1RN A等位基因的患者VAS评分、ODI评分分别高于其他2组患者(P=0.039、0.027)。结论IL-1B T/IL-1RN A基因型椎间盘突出症患者发生疼痛风险更高,恢复程度更差,而IL-1A T/IL-1RN A基因型对于患者神经痛的发生无影响。

Objective To investigate the influence of genetic variability in interleukin-1(IL-1)on the risk of clinical outcome after disc herniation.Methods A total of 96 patients with lumbar disc herniation who were treated in our hospital from May 2016 to January 2018 were enrolled in the study.Patients were divided into three groups according to the alleles IL-1A and IL-1RN genes:(1)IL-1A C/C and IL-1RN G/G group(n=20);(2)IL-1A*/T or IL-1RN*/A group(n=53);(3)IL-1A*/T and IL-1RN*/A group(n=23).Based on IL-1B and IL-1RN genes,patients were further divided into:(1)IL-1B C/C and IL-1RN G/G group(n=9);(2)IL-1B*/T or IL-1RN*/A group(n=50);(3)IL-1B*/T and IL-1RN*/A group(n=37).At 6 months and 12 months after discharged,all patients received examination,VAS scale was used to assess the degree of pain,ODI scale was used to evaluate the quality of life.The PCR technique was used to perform single nucleotide polymorphism detection at three sites:IL-1A C/T,IL-1B T/C and IL-1RN G/A,and their relationship with VAS score and ODI score was analyzed.Results There were no significant differences in VAS score and ODI score between different IL-1A and Il-1RN genotypes groups(P=0.175,0.055).But the combination of IL-1B allele T and IL-1RN allele A had higher VAS and ODI scores than the other two groups(P=0.039,0.027).Conclusion Lumbar disc herniation patients with IL-1B T/IL-1RN A genetype have a higher risk of pain and worse recovery,while the IL-1A T/IL-1RN A genetype has no influence on the occurrence of neuropathic pain.