终板炎及外周血CXCL10、MMP-1水平与经皮椎间孔镜下髓核摘除术后复发的相关性研究

Correlation between Endplate Inflammation,CXCL10 and MMP-1 Levels in Peripheral Blood and Recurrence after Percutaneous Interforaminal Nucleus Pulposus Extraction

目的:探究终板炎及外周血CXC趋化因子配体10(CXC chemokine ligand-10,CXCL10)、基质金属蛋白酶1(matrix metalloproteinase-1,MMP-1)水平与经皮椎间孔镜下髓核摘除术后复发的相关性。方法:回顾性分析惠州市中心人民医院2020年1月-2021年6月收治的180例经皮椎间孔镜下髓核摘除术治疗的腰椎间盘突出症患者。两组均行经皮椎间孔镜下髓核摘除术,术后8个月随访,通过核磁共振影像学结果分为未复发组(n=96)与复发组(n=84)。观察两组术前、术后8个月CXCL10、MMP-1、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、CXC趋化因子受体3(CXC-chemokine receptor 3,CXCR3)水平变化及视觉模拟评分法(VAS)、日本骨科协会评估治疗(JOA)评分。分析外周血CXCL10、MMP-1水平及终板炎与经皮椎间孔镜下髓核摘除术后复发的相关性。结果:术前两组CXCL10、MMP-1、TNF-α、CXCR3水平及终板炎发生率比较,差异无统计学意义(P>0.05)。术后8个月,复发组的CXCL10、MMP-1、TNF-α、CXCR3水平及终板炎发生率显著高于未复发组(P<0.05)。术前,两组VAS、JOA评分比较,差异无统计学意义(P>0.05)。术后8个月,未复发组VAS评分显著低于复发组,JOA评分显著高于复发组(P<0.05)。Spearman相关性分析得出终板炎、外周血CXCL10、MMP-1水平与经皮椎间孔镜下髓核摘除术后复发具有良好的正相关性。结论:终板炎、外周血CXCL10和MMP-1水平与经皮椎间孔镜下髓核摘除术后复发呈现正相关性。

Objective:To investigate the correlation between endplate inflammation,CXC chemokine ligand-10(CXCL10)and matrix metalloproteinase-1(MMP-1)levels in peripheral blood and recurrence after percutaneous interforaminal nucleus pulposus extraction.Method:Retrospective analysis 180 patients with lumbar disc herniation treated by percutaneous interforaminal nucleus pulposus extraction who were admitted to Huizhou Central People’s Hospital from January 2020 to June 2021.All patients were treated with percutaneous interforaminal nucleus pulposus extraction.Follow up for 8 month after operation,they were divided into non recurrence group(n=96)and recurrence group(n=84)according to the results of nuclear magnetic resonance imaging.The CXCL10,MMP-1,tumor necrosis factor-α(TNF-α)and CXC-chemokine receptor 3(CXCR3)level changes and visual analogue scale(VAS),Japan Orthopedic Association assessment treatment(JOA)score were observed before and 8 months after operation in both groups.The correlation between peripheral blood CXCL10,MMP-1 levels,endplate inflammation and recurrence after percutaneous interforaminal nucleus pulposus extraction were analyzed.Result:There were no significant differences in CXCL10,MMP-1,TNF-α,CXCR3 levels and incidence of endplate inflammation in both groups before operation(P>0.05).Eight months after operation,the levels of CXCL10,MMP-1,TNF-αand the incidence of endplate inflammation in the recurrence group were significantly higher than those in the non recurrence group(P<0.05).Before operation,there were no significant differences in VAS and JOA scores between the two groups(P>0.05).After operation,the VAS score in the non recurrence group was significantly lower than that in the recurrence group,and the JOA score was significantly higher than that in the recurrence group(P<0.05).Spearman correlation analysis showed that endplate inflammation,CXCL10 and MMP-1levels in peripheral blood had good positive correlation with the recurrence after percutaneous interforaminal nucleus pulposus extraction.Conclusion:The endplate inflammation and CXCL10 and MMP-1 levels in peripheral blood are positively correlated with the recurrence of percutaneous interforaminal nucleus pulposus extraction.