摘要
目的观察颈椎前路手术治疗脊髓型颈椎病(CSM)对炎性细胞因子浓度的影响。方法选择53例CSM患者(观察组)及同期健康检查人群50例(对照组)作为研究对象。观察组患者在全身麻醉之后行颈椎前路减压融合内固定术(ACDF)或颈前路椎体次全切除植骨融合内固定术(ACCF)。采用日本骨科协会(JOA)评分标准对CSM患者术前及术后进行神经功能评分。对不同病程CSM患者的术后临床疗效进行分析。测定观察组和对照组的炎性细胞因子浓度。结果病程在半年以下的CSM患者术后临床疗效优良率(80.00%)显著优于病程在半年以上的CSM患者(52.17%),差异有统计学意义(P<0.05)。CSM患者在术后5d的临床疗效优良率为67.92%(36/53),JOA评分为(14.14±2.61)分,显著高于术前评分[(9.62±1.88)分],差异有统计学意义(P<0.05)。手术后12个月,观察组患者的血清白细胞介素(IL)-6、IL-8和肿瘤坏死因子-α(TNF-α)浓度较术前显著降低(P<0.05),与对照组差异无统计学意义(P>0.05)。结论颈椎前路手术治疗CSM,疗效确切,能够有效降低炎性细胞因子浓度,值得临床推广使用。
Objective To observe the influence of anterior cervical operation on the inflammatory cytokine lev‐els in cervical spondylotic myelopathy（CSM ） .Methods 53 cases of CSM were selected as the observation group and contemporaneous 50 individuals of healthy physical examination as the control group .The observation group was per‐formed the anterior cervical decompression and internal fixation（ACDE） or anterior cervical corpectomy and fusion （ACCF） .The preoperative and postoperative neural function scores were evaluated by using the the Japanese Ortho‐paedic Association（JOA） criteria .The postoperative clinical efficacy in the CSM patients with different disease cour‐ses was analyzed .The inflammatory cytokines levels were measured in the two groups .Results The excellent and good rate of clinical effect in the CSM patients with the disease duration less than half a year was 80 .00% ,which was significantly better than that with the disease duration more thn half a year（52 .17% ） ,the difference was statistically significant（P〈 0 .05） .The excellent and good rate of clinical effect on postoperative 5 d in the CSM patients was 64 .15% （34/53） ,and the JOA scores were（14 .14 ± 2 .61）points ,which were significantly higher than（9 .62 ± 1 .88） points before operation ,the difference was statistically significant（P〈 0 .05） .The serum IL‐6 ,IL‐8 and TNF‐α levels at 12 months after operation in the observation group significantly higher than after 12 months of surgery ,the differ‐ence was statistically significant（P〈 0 .05） .Differences in serum IL‐6 ,IL‐8 ,and TNF‐α in comparison with the con‐trol group were were significantly decreased compared with before operation（P 〈 0 .05） ,but the difference compared with the control group had no statistical significance（P〉0 .05） .Conclusion The anterior cervical surgery has defi‐nite effect for treating CSM ,can effectively reduce the inflammatory cytokines levels and is worthy being promoted and applied in clinic .
出处
《检验医学与临床》
CAS
2015年第19期2914-2916,共3页
Laboratory Medicine and Clinic
基金
江苏大学2012年度医学临床科技发展基金资助项目(JLY20120054)
关键词
颈椎前路手术
脊髓型颈椎病
炎性细胞因子
internal fixation of cervical corpectomy decompression and fusion
cervical myelopathy
in-flammatory cytokines
