SDF-1、IL-17、OPG与LDH经皮脊柱椎间孔镜术后疼痛关系及对腰椎功能的影响

Relationship between SDF-1,IL-17,OPG and pain after percutaneous spinal foraminal endoscopy in the USpbetweenSDr-i,iL-rl,orGanupamater Fcutaicouss iaeiuoscopyntn reatment of lumbar disc herniation and their effects on lumbar functions

目的 探讨基质细胞衍生因子1 (stromal cell-derived factor 1,SDF-1)、白细胞介素-17(interleukin-17,IL-17)、骨保护素(osteoprotegerin,OPG)与腰椎间盘突出症(lumbar disc herniation,LDH)经皮脊柱椎间孔镜术后疼痛关系及对腰椎功能影响。方法 选取2019年7月至2021年7月229例行经皮脊柱椎间孔镜术LDH患者,根据术后3个月是否伴有腰腿疼痛分为疼痛组(n=62)、无疼痛组(n=167),比较两组基线资料、术前、术后1个月、3个月血清SDF-1、IL-17、OPG,使用Logistic回归分析术后疼痛相关因素,采用受试者工作特征曲线(receiver operating characteristic,ROC)及ROC下面积(AUC)分析血清SDF-1、IL-17、OPG预测术后疼痛价值,使用Pearson分析术后3个月血清SDF-1、IL-17、OPG与Oswestry功能障碍指数(oswestry disability index,ODI)关系。结果 疼痛组术后3个月ODI高于无疼痛组(P <0.05);疼痛组术后3个月SDF-1、IL-17高于术后1个月(P <0.05);疼痛组术后1个月、3个月SDF-1、IL-17高于无疼痛组,OPG低于无疼痛组(P <0.05);术后3个月SDF-1、IL-17、OPG均与疼痛发生显著相关(P <0.05);ROC曲线显示AUC分别为0.814、0.788、0.816、0.923;术后3个月SDF-1、IL-17与ODI呈正相关(r=0.730、0.636,P均<0.001),OPG与ODI呈负相关(r=-0.834,P <0.001)。结论 LDH经皮脊柱椎间孔镜术后疼痛患者血清SDF-1、IL-17、OPG水平升高,三者联合检测对术后疼痛具有较高预测价值,且与腰椎功能密切相关。

Objective To investigate the relationship between stromal cell-derived factor 1(SDF-1),interleukin-17(IL-17),osteoprotegerin(OPG)and pain after percutaneous spinal foraminoscopy in the treatment of lumbar disc herniation(LDH)and the effect on lumbar spine function.Methods Two hundred and twenty-nine patients with percutaneous spinal foraminoscopy for LDH from July 2019 to July 2021 were selected,and were divided into pain group(n=62)and non-pain group(n=167)according to the low back pain at 3 months postoperatively.Baseline data,serum SDF-1,IL-17,and OPG preoperatively,1 month postoperatively,and 3 months postoperatively were compared between the two groups.Logistic regression analysis was used to analyze the factors associated with postoperative pain.Receiver operator characteristic curve(ROC)and area under ROC(AUC)were used to analyze the value of serum SDF-1,IL-17,and OPG in predicting postoperative pain.Pearson analysis was used to evaluate the relationship between serum SDF-1,IL-17,OPG and ODI 3 months postoperatively.Results ODI scores at 3 months postoperatively were higher in the pain group than in the non-pain group(P<0.05);SDF-1 and IL-17 at 3 months postoperatively were higher than the data 1 month postoperatively in the pain group(P<0.05);SDF-1 and IL-17 at 1 month and 3 months postoperatively were higher in the pain group;OPG was lower in the non-pain group(P<0.05);SDF-1,IL 17 and OPG were all significantly correlated with the occurrence of pain(P<0.05);ROC curves showed AUCs of 0.814,0.788,0.816,and 0.923,respectively;SDF-1 and IL-17 were positively correlated with ODI scores at 3 months postoperatively(r=0.730 and 0.636,both P<0.001).OPG was negatively correlated with ODI scores(r=-0.834,P<0.001).Conclusions Serum SDF-1,IL-17,and OPG levels are elevated in patients with pain after LDH percutaneous spinal foraminotomy.Combined test of serum SDF-1,IL-17 and OPG has a high predictive value for postoperative pain,which is closely related to lumbar spine function.