ICAM-1、HSP70及PAF水平变化与脊髓损伤患者病情及预后的关系

Relationship between the changes of ICAM-1,HSP70 and PAF levels and the condition and prognosis of patients with spinal cord injury

目的研究细胞间粘附分子-1(ICAM-1)、热休克蛋白70(HSP70)及血小板活化因子(PAF)水平变化与脊髓损伤患者病情、预后的关系。方法选取2016年6月至2018年6月于本院接受诊治的84例脊髓损伤(SCI)患者临床资料作为研究组,根据ASIA分级标准将SCI患者分为:脊髓完全损伤者(A组=43),脊髓不完全损伤者(B组=24),脊髓震荡者(C组=17)。并选取同期进行健康检查的96例正常人群作为对照组。比较ICAM-1、HSP70及PAF水平在各组间的情况,记录所有患者在随访时间内预后情况,采用多元Logistic回归分析影响脊髓损伤患者预后不良的危险因素。结果研究组患者ICAM-1、HSP70及PAF水平明显高于对照组,差异有统计学意义(P<0.05);ICAM-1、HSP70及PAF水平显示:A组>B组>C组,差异有统计学意义(P<0.05);84例患者经两年随访后显示,57例患者预后良好,27例患者预后不良,预后不良率为32.14%。经多元Logistic回归显示,患者受伤至手术时间、外伤类型、ICAM-1、HSP70及PAF水平为SCI患者预后不良的独立危险因素(P<0.05)。结论 ICAM-1、HSP70及PAF在SCI患者中明显升高,且与患者预后关系密切,可作为预测SCI患者预后的分子标志物和治疗的潜在的靶点。

Objective To study the relationship between the changes of intercellular adhesion molecule-1(ICAM-1),heat shock protein 70(HSP70)and platelet activating factor(PAF)levels and the condition and prognosis of patients with spinal cord injury. Methods The clinical data of 84 patients with spinal cord injury(SCI)who were diagnosed and treated in our hospital from June 2016 to June 2018 were selected as the research group. According to the ASIA grading standard,the SCI patients were divided into:patients with complete spinal cord injury(Group A,n=43)and incomplete spinal cord injuries(Group B,n=24),patients with spinal cord concussion(Group C,n=17). And 96 healthy persons who underwent health check in the same period was selected as the control group. The levels of ICAM-1,HSP70,and PAF among the groups were compared,and the prognosis of all patients during the follow-up period was recorded. Multivariate Logistic regression was used to analyze the risk factors that affect the poor prognosis of patients with spinal cord injury. Results The levels of ICAM-1,HSP70 and PAF in the study group were significantly higher than those in the control group,and the difference was statistically significant(P<0.05). The levels of ICAM-1,HSP70 and PAF are as follows:Group A>Group B>Group C,and the difference was statistically significant(P<0.05). After two years of follow-up,84 patients showed that 57 patients had a good prognosis,27 patients had a poor prognosis,and the poor prognosis rate was 32.14%. Multivariate Logistic regression showed that the time from injury to operation,type of injury,ICAM-1,HSP70 and PAF levels were independent risk factors for poor prognosis in patients with SCI(P<0.05). Conclusion The levels of ICAM-1,HSP70 and PAF are significantly increased in SCI patients,and are closely related to the prognosis of patients,and can be used as molecular markers in predicting the prognosis of SCI patients and potential targets for treatment.