椎间盘脱出患者非手术治疗后突出物重吸收情况及其影响因素

Herniation reabsorption in patients with disc prolapse after non-surgical treatment and its influencing factors

目的:观察椎间盘脱出患者非手术治疗后的突出物重吸收情况,分析突出物不良组的影响因素。方法:选取2019-01~2020-01乳山市人民医院就诊的108例椎间盘脱出患者,均接受非手术治疗,连续治疗3个月。治疗结束时评估突出物重吸收情况并分为不良组与良好组。调查两组患者一般资料,检测研究所需实验室指标并比较,通过单因素与多因素分析,找出椎间盘脱出患者非手术治疗后突出物重吸收不良的影响因素。结果:108例椎间盘脱出患者,经非手术治疗后,突出物重吸收不良的患者有34例(31.48%);不良组与良好组腰椎前凸角(LL)、基质金属蛋白酶(MMPs)-3、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平对比,差异有统计学意义(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);经回归分析结果显示,LL低、MMPs-3、VEGF及TNF-α低表达均是椎间盘脱出患者非手术治疗后突出物重吸收不良的影响因素(OR<1,P<0.05)。结论:椎间盘脱出患者非手术治疗后突出物重吸收不良风险较高,可能受LL低、MMPs-3、VEGF和TNF-α低表达等因素的影响。

Objective:To investigate the situation of herniation reabsorption and the influencing factors of herniation malabsorption in patients with intervertebral disc prolapse after non-surgical treatment.Methods:A total of 108 patients with disc prolapse in Rushan People's Hospital from January 2019 to January 2020 were selected for a prospective study.All patients received non-surgical treatment for 3 months.At the end of treatment,the protrusion reabsorption was assessed and divided into poor group and good group.The general data of patients in the two groups were investigated,laboratory indicators were tested and compared,and the influencing factors of protrusion reabsorption in patients with disc prolapse after non-surgical treatment were analyzed by univariate and multivariate factors.Results:Of 108 patients with disc prolapse,34 patients 31.48%had poor reabsorption of protrusion after non-surgical treatment.The levels of LUMBAR lordosis Angle(LL),matrix metalloproteinase-3(MMPS-3),vascular endothelial growth factor(VEGF)and tumor necrosis factor-α(TNF-α)were significantly different between the poor group and the good group(P<0.05),but there was no significant difference in other data between the groups(P>0.05).Regression analysis showed that low LL,low EXPRESSION of MMPS-3,VEGF and TNF-αwere the influencing factors of protrusion reabsorption in patients with disc prolapse after non-surgical treatment(OR<1,P<0.05).Conclusion Patients with disc prolapse have a higher risk of protrusion reabsorption after non-surgical treatment,which may be affected by low LL,low expression of MMPS-3,VEGF and TNF-α.