血清瘦素和MCP-1浓度预测腰痛持续时间的价值

Effect of serum leptin and MCP-1 concentration on predicting duration of low back pain

目的探讨血清瘦素和单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)浓度预测腰痛持续时间的价值。方法选择2018年6月~2020年6月在本院就诊的急性腰痛(acute low back pain,ALBP)患者作为ALBP组,抽取在本院接受体检的健康受试者107例作为对照组,根据是否进展为持续性腰痛(persistent low back pain,PLBP)将ALBP组患者分为PLBP亚组和非PLBP亚组。观察不同组别和不同亚组间MCP-1、瘦素、脂联素和C反应蛋白(C-reactive protein,CRP)水平,分析MCP-1和瘦素对PLBP的预测价值。结果ALBP组和对照组脂联素水平相比,差异无统计学意义(P>0.05);ALBP组瘦素、MCP-1水平显著低于对照组(P<0.05),CRP水平显著高于对照组(P<0.05)。PLBP组和非PLBP组脂联素水平差异无统计学意义(P>0.05);PLBP组患者瘦素、MCP-1水平低于非PLBP组,CRP水平高于非PLBP组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,平衡其他临床因素后,MCP-1≥603 pg/mL、瘦素≥6.3 ng/mL是PLBP的保护性因素(P<0.05)。MCP-1(阈值603 pg/mL)和瘦素(阈值6.3 ng/mL)预测PLBP的灵敏度分别为64.5%和87.1%,特异度分别是84.2%和68.4%。结论瘦素和MCP-1可能参与了ALBP和PLBP的病理生理进程,对PLBP的早期预测和识别具有重要意义。

Objective To explore the value of serum leptin and monocyte chemoattractant protein-1(MCP-1)in predicting the duration of low back pain.Methods Patients with acute low back pain(ALBP)in our hospital from June 2018 to June 2020 were selected as the study group,and 107 healthy patients who received physical examination in our hospital were selected as the control group.Patients in the study group were divided into PLBP subgroup and non PLBP subgroup according to whether the patients in the study group developed persistent low back pain(PLBP).The levels of MCP-1,leptin,adiponectin and C-reactive protein(CRP)in different groups and subgroups were observed,and the predictive value of MCP-1 and leptin for PLBP was analyzed.Results There was no significant difference in adiponectin level between ALBP group and control group(P>0.05).The leptin and MCP-1 levels in the ALBP group were lower than those in the control group(P<0.05),and CRP level was higher than that in control group(P<0.05).There was no significant difference in adiponectin levels between PLBP group and non PLBP group(P>0.05).The leptin and MCP-1 levels in PLBP group were lower than those in non PLBP group,and CRP levels were higher than those in non PLBP group(P<0.05).Multivariate logistic analysis showed that after balancing other clinical factors,MCP-1≥603pg/mL and leptin≥6.3 ng/mL were the influencing factors of PLBP(P<0.05).The sensitivity and specificity of MCP-1(threshold 603pg/mL)and leptin(threshold6.3ng/mL)in predicting PLBP was 64.5%and 87.1%,84.2%and 68.4%,respectively.Conclusion Leptin and MCP-1 may participate in the pathophysiological process of ALBP and PLBP,which is of great significance for the early prediction and recognition of PLBP.