血清HMGB1、CTRP3水平与腰椎椎管狭窄症患者疼痛程度及腰椎功能的关系

Relationship between serum HMGB1 and CTRP3 levels and the degree of pain and lumbar function in patients with lumbar spinal stenosis

目的探讨血清高迁移率族蛋白B1(HMGB1)、C1q/TNF相关蛋白(CTRP)3与患者疼痛程度及腰椎功能的关系。方法回顾性选取2021年9月至2023年8月于该院治疗的145例腰椎椎管狭窄症患者作为研究对象,根据患者腰椎狭窄节段数分为单节段组(89例)和多节段组(56例)。采用酶联免疫吸附试验检测两组血清HMGB1、CTRP3水平,比较两组疼痛程度、腰椎功能等临床病理特征及血清HMGB1、CTRP3水平,分析血清HMGB1、CTRP3水平与疼痛程度及腰椎功能的相关性,采用多因素Logistic回归分析患者腰椎狭窄节段数的影响因素,采用受试者工作特征(ROC)曲线分析血清HMGB1、CTRP3水平对患者腰椎功能的诊断价值。结果多节段组视觉模拟评分法(VAS)评分和血清HMGB1水平高于单节段组(P<0.05),日本骨科协会(JOA)评分和血清CTRP3水平低于单节段组(P<0.05)。腰椎椎管狭窄症患者血清HMGB1水平与CTRP3、JOA评分均呈负相关(r=-0.544、-0.616,P<0.001),与VAS评分呈正相关(r=0.453,P<0.001);血清CTRP3水平与VAS评分呈负相关(r=-0.550,P<0.001),与JOA评分呈正相关(r=0.619,P<0.001);JOA评分与VAS评分呈负相关(r=-0.485,P<0.001)。多因素Logistic回归分析结果表明,JOA评分和血清CTRP3水平为患者多节段狭窄的保护因素(P<0.05),VAS评分和血清HMGB1水平为患者多节段狭窄的危险因素(P<0.05)。ROC曲线分析表明,血清HMGB1、CTRP3水平可以作为腰椎椎管狭窄症患者腰椎功能的诊断指标,二者联合诊断的效果更好(P<0.05)。结论腰椎椎管狭窄症患者血清HMGB1、CTRP3水平与患者疼痛程度及腰椎功能密切相关,两指标联合可用于腰椎椎管狭窄症患者腰椎功能的临床诊断。

Objective To investigate the relationship between serum high mobility group protein B1(HMGB1),C1q/TNF-associated protein 3(CTRP3)and pain degree and lumbar function.Methods A total of 145 patients with lumbar spinal stenosis treated in the hospital from September 2021 to August 2023 were retrospectively selected as the study objects,and were divided into single-segment group(89 cases)and multi-segment group(56 cases)according to the number of lumbar spinal stenosis segments.Serum levels of HMGB1 and CTRP3 were detected by enzyme-linked immunosorbent assay.The clinicopathological features such as pain degree,lumbar function and serum levels of HMGB1 and CTRP3 were compared between the two groups.The correlation of serum HMGB1 and CTRP3 levels with pain degree and lumbar function were analyzed,and the factors influencing the number of segments of lumbar stenosis were analyzed by multivariate Logistic regression.The diagnostic value of serum HMGB1 and CTRP3 levels on lumbar function of patients was analyzed by receiver operating characteristic(ROC)curve.Results Visual analogue scale(VAS)score and serum HMGB1 level in multi-segment group were higher than those in single-segment group(P<0.05),Japanese Orthopaedic Association(JOA)score and serum CTRP3 level were lower than those in single-segment group(P<0.05).Serum HMGB1 level was negatively correlated with CTRP3 and JOA score in patients with lumbar spinal stenosis(r=-0.544,-0.616,P<0.001),and positively correlated with VAS score(r=0.453,P<0.001).The serum CTRP3 level was negatively correlated with VAS score(r=-0.550,P<0.001),and positively correlated with JOA score(r=0.619,P<0.001).JOA score was negatively correlated with VAS score(r=-0.485,P<0.001).Multivariate Logistic regression analysis showed that JOA score and serum CTRP3 level were protective factors for multi-segmental stenosis(P<0.05),VAS score and serum HMGB1 level were risk factors for multi-segmental stenosis(P<0.05).The analysis of ROC curve showed that serum HMGB1 and CTRP3 levels could be used as diagnostic indexes of lumbar spinal function in patients with lumbar spinal stenosis,and the combined diagnosis effect was better(P<0.05).Conclusion Serum levels of HMGB1 and CTRP3 are closely related to pain degree and lumbar function in patients with lumbar spinal stenosis.The combination of the two indexes can be used for the clinical diagnosis of lumbar function in patients with lumbar spinal stenosis.