摘要
目的:探究脊柱骨折伴脊髓损伤(spinal cord injury,SCI)患者肿瘤坏死因子(TNF-α)、神经突起因子(Neuritin)水平与神经功能的关系及其对预后的预测价值。方法:选取2021年3-11月中国人民解放军联勤保障部队第九〇九医院骨科收治的100例脊柱骨折伴SCI患者,根据SCI程度将其分为A组(n=30,完全性脊髓损伤)和B组(n=70,不完全性脊髓损伤),选取同一时间在本院进行体检的80例正常志愿者作为空白组。三组患者均检测TNF-α、Neuritin水平,并评价A、B组的神经功能。比较三组、不同神经功能分级患者TNF-α与Neuritin水平。统计100例患者骨折后6个月分组情况,并比较预后不佳组和预后良好组TNF-α与Neuritin水平。分析TNF-α与Neuritin对脊柱骨折伴SCI患者预后的预测价值。结果:A、B组TNF-α和Neuritin水平均显著高于空白组(P<0.05),A组TNF-α、Neuritin水平均显著高于B组(P<0.05)。A、B、C、D级患者TNF-α、Neuritin水平比较差异有统计学意义(P<0.05),且从D级至A级,TNF-α、Neuritin水平呈上升趋势。Spearman秩相关结果显示,TNF-α、Neuritin与ASIA分级均呈正相关(r=0.297、0.702,P<0.001)。100例患者骨折6个月后,36例患者预后良好,64患者预后不佳。预后良好组TNF-α、Neuritin水平均明显低于预后不佳组(P<0.05)。TNF-α的曲线下面积(AUC)是0.837(95%CI:0.801,0.926),敏感度为0.712,特异度为0.781(P<0.001);Neuritin的AUC是0.843(95%CI:0.750,0.937),敏感度为0.786,特异度为0.739(P<0.001);TNF-α与Neuritin联合检测的AUC是0.938(95%CI:0.876,0.989),敏感度为0.879,特异度为0.817(P<0.001)。结论:脊柱骨折伴SCI患者的血清TNF-α和Neuritin水平与神经功能损伤程度存在正相关性,TNF-α和Neuritin联合检测能够对脊柱骨折伴SCI患者预后进行预测。
Objective:To explore the relationship among tumor necrosis factor-α(TNF-α)and Neuritin and neurological function in patients with spinal fracture and spinal cord injury(SCI)and their predictive value for prognosis.Method:From March to November 2021,100 patients with spinal fracture and SCI admitted to the Department of Orthopaedics of the Chinese People’s Liberation Army 909th Hospital of Joint Logistics Support Force were selected and divided into group A(n=30,complete SCI)and group B(n=70,incomplete SCI)according to the degree of SCI,and 80 normal volunteers who had physical examinations in our hospital at the same time were selected as the blank group.TNF-α,Neuritin levels were detected in patients of three groups,and the neural function of groups A and B was evaluated.The levels of TNF-αand Neuritin in the three groups and patients with different neurological function grades were compared.The grouping condition of 100 patients was counted 6 months after fracture,and the levels of TNF-αand Neuritin were compared between the poor prognosis group and the good prognosis group.The predictive value of TNF-αand Neuritin for the prognosis of patients with spinal fracture and SCI was analyzed.Result:The levels of TNF-αand Neuritin in groups A and B were significantly higher than those in blank group(P<0.05),and the levels of TNF-αand Neuritin in group A were significantly higher than those in group B(P<0.05).There were significant differences in the levels of TNF-αand Neuritin in patients with grade A,B,C and D(P<0.05),and the levels of TNF-αand Neuritin increased from grade D to grade A.Spearman rank correlation result showed that TNF-αand Neuritin were positively correlated with ASIA grade(r=0.297,0.702,P<0.001).Six months after fracture in 100 patients,36 patients had a good prognosis and 64 patients had a poor prognosis.The levels of TNF-αand Neuritin in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05).The area under curve(AUC)of TNF-αwas 0.837(95%CI:0
作者
吴采荣
许遵营
苏瑞龙
WU Cairong;XU Zunying;SU Ruilong(The Chinese People’s Liberation Army 909th Hospital of Joint Logistics Support Force,Zhangzhou 363000,China;不详)
出处
《中外医学研究》
2022年第35期76-80,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
脊髓损伤
脊柱骨折
肿瘤坏死因子
神经突起因子
神经功能
预后
相关性
Spinal cord injury
Spinal fracture
Tumor necrosis factor
Neuritin
Neurological function
Prognosis
Correlation
