摘要
目的观察脊柱骨折合并脊髓损伤患者血清白细胞介素-17(IL-17)、分泌型蛋白Dickkopf-l(DKK-1)水平的变化,并探讨二者对患者预后不良的预测价值。方法选取2018年10月至2022年8月在该院就诊的133例接受椎管减压术治疗的脊柱骨折合并脊髓损伤患者作为研究组,根据美国脊柱损伤协会(ASIA)神经功能等级,将其分为预后良好组(80例)和预后不良组(53例)。另选取同期在本院接受椎管减压术治疗的128例单纯脊柱骨折患者作为对照组,收集脊柱骨折合并脊髓损伤患者的临床资料。采用酶联免疫吸附试验(ELISA)检测所有患者血清IL-17、DKK-1水平。多因素Logistic回归分析患者预后影响因素。受试者工作特征(ROC)曲线分析IL-17、DKK-1水平对患者预后不良的诊断价值。结果研究组血清IL-17[(23.18±4.85)pg/mL vs.(12.97±3.91)pg/mL]、DKK-1水平[(2.48±0.41)ng/mL vs.(1.37±0.26)ng/mL]均高于对照组,差异有统计学意义(P<0.001)。预后不良组患者血清IL-17[(26.61±4.85)pg/mL vs.(20.91±3.81)pg/mL]、DKK-1水平[(2.83±0.48)ng/mL vs.(2.25±0.39)ng/mL]均显著高于预后良好组,差异有统计学意义(P<0.001)。IL-17、DKK-1为影响患者预后的独立危险因素(P<0.05)。血清IL-17、DKK-1及二者联合诊断患者预后不良的曲线下面积(AUC)分别为0.822(95%CI:0.746~0.883)、0.796(95%CI:0.718~0.861)和0.910(95%CI:0.848~0.953),联合诊断效能高于单独检测效能(Z联合诊断-IL-17=2.034,P=0.042;Z联合诊断-DKK-1=2.422,P=0.015)。结论脊柱骨折合并脊髓损伤患者血清IL-17、DKK-1水平升高,且二者水平对患者预后有一定诊断价值。
Objective To observe the changes in serum levels of interleukin-17(IL-17)and secretory protein Dickkopf-1(DKK-1)in patients with spinal fracture and spinal cord injury,and to explore their predictive value for poor prognosis.Methods A total of 133 patients with spinal fractures and spinal cord injury who underwent spinal canal decompression surgery at the hospital from October 2018 to August 2022 were regarded as the study group.According to the american spinal injury association(ASIA)neurological function level,they were separated into the good prognosis group(80 cases)and the poor prognosis group(53 cases).Another 128 patients with simple spinal fractures who underwent spinal canal decompression surgery in the hospital were collected as the control group.Clinical data of patients with spinal fractures and spinal cord injury were collected.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum IL-17 and DKK-1 levels in all patients.Logistic regression was used to analyze factors influencing the prognosis of patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum IL-17 and DKK-1 levels for poor prognosis in patients.Results The serum levels of IL-17[(23.18±4.85)pg/mL vs.(12.97±3.91)pg/mL]and DKK-1[(2.48±0.41)ng/mL vs.(1.37±0.26)ng/mL]in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The serum IL-17[(26.61±4.85)pg/mL vs.(20.91±3.81)pg/mL]and DKK-1 levels[(2.83±0.48)ng/mL vs.(2.25±0.39)ng/mL]in the poor prognosis group were obviously higher than those in the good prognosis group,and the differences were statistically significant(P<0.001).The independent risk factors for poor prognosis in patients included IL-17 and DKK-1(P<0.05).The area under the curve(AUC)of serum IL-17,DKK-1 and their combined diagnosis for poor prognosis in patients was 0.822(95%CI:0.746-0.883),0.796(95%CI:0.718-0.861),and 0.910(95%CI:0.848-0.953),respectively.The diagnostic efficacy of the combination was higher than those of single detection(Z=2.034,P=0.042;Z=2.422,P=0.015).Conclusion Serum IL-17 and DKK-1 levels are elevated in patients with spinal fracture combined with spinal cord injury,and both have diagnostic value for the prognosis of the patients.
作者
郝强
孙丹丹
HAO Qiang;SUN Dandan(Department of Orthopedics,Daqing Oilfield General Hospital,Daqing,Heilongjiang 163000,China)
出处
《国际检验医学杂志》
CAS
2024年第22期2800-2804,共5页
International Journal of Laboratory Medicine
