摘要
目的探讨血清基质金属蛋白酶-3(MMP-3)、网膜素-1(Omentin-1)表达水平与退行性腰椎管狭窄症(DLSS)患者Oswestry功能障碍指数(ODI)评分的相关性。方法选取2020年9月至2022年3月在该院骨科接受治疗的94例DLSS患者作为试验组,并选取同期90例体检健康者作为对照组。检测血清MMP-3、Omentin-1表达水平。采用磁共振检测总无脂肪多裂肌横截面积(TFCSA)、总多裂肌横截面积(TCSA),并计算TFCSA/TCSA。采用Pearson相关分析DLSS患者血清MMP-3、Omentin-1表达水平与ODI评分的关系。通过多因素Logistic回归分析患者发生重度功能障碍的影响因素。采用受试者工作特征(ROC)曲线分析血清MMP-3、Omentin-1对重度功能障碍的预测价值。结果试验组血清MMP-3表达水平为(45.84±7.97)ng/mL,明显高于对照组的(32.57±6.24)ng/mL(P<0.05),血清Omentin-1表达水平为(56.46±12.20)ng/mL,明显低于对照组的(76.85±14.32)ng/mL(P<0.05)。试验组TFCSA、TFCSA/TCSA[(0.98±0.10)cm^(2)和0.66±0.12]明显低于对照组[(1.26±0.14)cm^(2)和0.82±0.16],差异均有统计学意义(P<0.05);试验组和对照组TCSA[(1.52±0.24)cm^(2)和(1.56±0.20)cm^(2)]比较,差异无统计学意义(P>0.05)。DLSS患者血清MMP-3表达水平与ODI评分呈正相关(r=0.426,P<0.05),Omentin-1表达水平、TFCSA、TCSA、TFCSA/TCSA均与ODI评分呈明显负相关(r=-0.339、-0.514、-0.517、-0.429,P<0.05)。多因素Logistic回归分析显示,Omentin-1表达水平、TFCSA升高是DLSS患者发生重度功能障碍的保护因子(P<0.05),MMP-3表达水平升高是DLSS患者发生重度功能障碍的危险因素(P<0.05)。血清MMP-3、Omentin-1联合检测评估DLSS患者重度功能障碍的曲线下面积优于任何一项单独检测(Z两项联合-MMP-3=2.036,Z两项联合-Omentin-1=2.113;均P<0.05)。结论DLSS患者血清MMP-3表达水平上调,血清Omentin-1表达水平下调,且二者联合检测对DLSS患者发生重度功能障碍有一定的预测价值。
Objective To investigate the correlation between serum matrix metalloproteinase-3(MMP-3),Omentin-1 expression and the Oswestry disability index(ODI)score in patients with degenerative lumbar spinal stenosis(DLSS).Methods A total of 94 patients with DLSS who received treatment in the Orthopedic Department of the hospital from September 2020 to March 2022 were selected as the experimental group.Simultaneously,90 healthy individuals undergoing physical examinations during the same period were selected as the control group.Serum expression levels of MMP-3 and Omentin-1 were measured.Magnetic resonance imaging(MRI)was used to detect the total fat-free cross-sectional area(TFCSA)and the total cross-sectional area(TCSA)of the multifidus muscle,and the TFCSA/TCSA ratio was calculated.Pearson correlation analysis was used to analyze the relationship between serum MMP-3 and Omentin-1 expression levels and ODI score in DLSS patients.Multivariate Logistic regression analysis was performed to analyze factors influencing the development of severe disability.Receiver operating characteristic(ROC)curve was plotted to evaluate the predictive value of serum MMP-3 and Omentin-1 for severe disability.Results The serum expression level of MMP-3 in the experimental group was(45.84±7.97)ng/mL,which was significantly higher than that in the control group[(32.57±6.24)ng/mL,P<0.05];the serum expression level of Omentin-1 was(45.84±7.97)ng/mL,which was lower than that in the control group[(76.85±14.32)ng/mL,P<0.05].The TFCSA and TFCSA/TCSA[(0.98±0.10)cm^(2) and 0.66±0.12]in the experimental group were significantly lower than those in the control group[(1.26±0.14)cm^(2) and 0.82±0.16],and the differences were statistically significant(P<0.05).However,there is no significant difference in TCSA between the experimental group and the control group[(1.52±0.24)cm^(2) and(1.56±0.20)cm^(2),P>0.05].In DLSS patients,serum MMP-3 level were positively correlated with the ODI score(r=0.426,P<0.05),while Omentin-1 level,TFCSA,TCSA,and TFCSA/T
作者
李健刚
安文涛
吕品
周浩
LI Jiangang;AN Wentao;LYU Pin;ZHOU Hao(Department of OrthopedicsⅣ,North China Medical Group Fengfeng General Hospital,Handan,Hebei,056200,China;Department of OrthopedicsⅡ,North China Medical Group Fengfeng General Hospital,Handan,Hebei,056200,China;Department of OrthopedicsⅢ,North China Medical Group Fengfeng General Hospital,Handan,Hebei,056200,China)
出处
《检验医学与临床》
CAS
2024年第21期3186-3190,共5页
Laboratory Medicine and Clinic
基金
河北省卫生健康委员会基金项目(20221560)。
