血清CCL2、CCL5、CXCL10与腰椎间盘突出症患者术后早期疼痛缓解的关系研究

Study on the Relationship between Serum CCL2,CCL5,CXCL10 and Early Postoperative Pain Relief in Patients with Lumbar Disc Herniation

目的:探讨血清C-C基序趋化因子配体2(CCL2)、CCL5、C-X-C基序趋化因子配体10(CXCL10)水平与腰椎间盘突出症(LDH)患者术后早期疼痛缓解的关系。方法:选取徐州医科大学附属医院208例LDH患者。根据术后7 d疼痛情况分为缓解组、未缓解组,检测并对比两组血清CCL2、CCL5、CXCL10水平。多因素Logistic回归模型分析LDH患者术后早期疼痛未缓解的影响因素。结果:208例LDH患者中有168例疼痛缓解,40例疼痛未缓解,疼痛未缓解率为(19.23%)。未缓解组血清CCL2、CCL5、CXCL10水平均高于缓解组(P<0.05)。未缓解组年龄≥40岁、体质量指数≥25 kg/m^(2)、术前视觉模拟评分法(VAS)评分≥6分、手术节段数为多节段、手术方式为开放减压融合术及椎间盘退变等级为Ⅳ-Ⅴ级比例、矢状面旋转程度高于缓解组(P<0.05)。Logistic回归结果显示,年龄≥40岁、体质量指数≥25 kg/m^(2)、术前VAS评分≥6分、手术节段数为多节段、椎间盘退变Ⅳ-Ⅴ级、矢状面旋转程度上升、血清CCL2水平上升、血清CCL5水平上升、血清CXCL10水平上升是影响LDH患者术后早期疼痛缓解的危险因素(P<0.05),而经皮显微通道手术是保护因素(P<0.05)。结论:CCL2、CCL5、CXCL10高表达会增加LDH患者术后早期疼痛未缓解发生风险。

Objective:To investigate the relationship between serum C-C motif chemokine ligand 2(CCL2),CCL5,C-X-C motif chemokine ligand 10(CXCL10)levels and early postoperative pain relief in patients with lumbar disc herniation(LDH).Methods:208 patients with LDH in Affiliated Hospital of Xuzhou Medical University were selected.patients were divided into remission group and non-remission group according to the pain 7 days after operation,the levels of serum CCL2,CCL5 and CXCL10 were detected and compared between two groups.The influencing factors of early postoperative pain in LDH patients were analyzed by multivariate Logistic regression model.Results:208 patients with LDH 168 had pain relief,40 had no pain relief,and the rate of no pain relief was(19.23%).The levels of serum CCL2,CCL5 and CXCL10 in non-remission group were higher than those in remission group(P<0.05).The proportion of age≥40 years,body mass index≥25 kg/m^(2),preoperative VAS score≥6 points,number of surgical segments,open decompression and fusion,IV-V grade of intervertebral disc degeneration,and sagittal rotation degree in non-remission group were higher than those in remission group(P<0.05).Logistic regression showed that,age≥40 years,body mass index≥25 kg/m^(2),preoperative Visual analogue scale(VAS)score≥6 points,number of surgical segments,IV-V grade of intervertebral disc degeneration,sagittal rotation degree increased,serum CCL2 level increased,serum CCL5 level increased,and serum CXCL10 level increased were risk factors affecting early postoperative pain relief in LDH patients(P<0.05),and percutaneous microchannel surgery was a protective factor(P<0.05).Conclusion:The CCL2,CCL5 and CXCL10 high expression of the three will increase the risk of patients with LDH early postoperative pain.