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| 脊柱骨折合并脊髓损伤患者血清Neuritin、NFL、S100B蛋白水平与术后预后不良的关系研究* |
| Study the relationship between serum Neuritin, NFL, S100B protein levels and poor postoperative prognosis in patients with spinal fracture complicated with spinal cord injury* |
| 投稿时间：2021-04-28 修订日期：2021-04-28 |
| DOI： |
| 中文关键词: 脊柱骨折 脊髓损伤 神经突起因子 神经丝轻链 S100B蛋白 预后 |
| 英文关键词: Spinal fracture Spinal cord injury Neurogenic factor Neural filament light chain S100B protein Prognosis |
| 基金项目:广东省中医药局科研项目（20191276） |
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| 摘要点击次数: 111 |
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| 中文摘要: |
| （深圳市中医院/广州中医药大学第四临床医学院骨二科 广东 深圳 518033）
摘要 目的：研究脊柱骨折合并脊髓损伤（SCI）患者血清神经突起因子（Neuritin）、神经丝轻链（NFL）、S100B蛋白水平与术后预后不良的关系。方法：将从2018年12月-2019年12月我院收治的60例脊柱骨折合并SCI患者纳入研究，记作损伤组，另取同期我院收治的单纯脊柱骨折未合并SCI患者60例作为无损伤组，再取同期体检的健康志愿者60例作为对照组。检测并比较三组血清Neuritin、NFL、S100B蛋白水平。此外，将损伤组患者按照术后预后的不同分作预后不良组25例和预后良好组35例，分析两组血清Neuritin、NFL、S100B蛋白水平以及临床资料的差异，并以多因素Logistic回归分析明确脊柱骨折合并SCI患者预后不良和各项影响因素的关系。通过受试者工作特征（ROC）曲线明确血清Neuritin、NFL、S100B蛋白水平联合检测预测脊柱骨折合并SCI患者预后不良的效能。结果：损伤组及无损伤组血清Neuritin、NFL、S100B蛋白水平均明显高于对照组，且损伤组上述三项血清学指标水平均高于无损伤组（均P＜0.05）。预后不良组椎管侵占率高于预后良好组，且血清Neuritin、NFL、S100B蛋白水平均高于预后良好组（均P＜0.05）。经多因素Logistic回归分析可得：椎管侵占率以及血清Neuritin、NFL、S100B蛋白水平较高均是脊柱骨折合并SCI患者预后不良的危险因素（P＜0.05）。血清Neuritin、NFL、S100B蛋白水平联合检测预测脊柱骨折合并SCI患者预后不良的曲线下面积、灵敏度、特异度、约登指数均高于上述三项指标单独检测。结论：脊柱骨折合并SCI患者血清Neuritin、NFL、S100B蛋白水平较高，且随着上述三项血清学指标水平的升高，患者预后不良风险更高。 |
| 英文摘要: |
| Objective: To study the relationship between serum neurogenic factor (Neuritin), neural filament light chain (NFL), S100B protein levels and poor postoperative prognosis in patients with spinal fracture complicated with spinal cord injury (SCI). Methods: From December 2018 - December 2019, 60 patients with spinal fracture complicated with SCI who were treated in our hospital were included in this study, and classified as injury group. Another 60 cases of patients with simple spinal fracture without SCI admitted in the same period were selected as the non-injury group, and another 60 cases of healthy volunteers receiving physical examination during the same period were selected as the control group. Serum Neuritin, NFL and S100B protein levels were detected and compared in the three groups. In addition, the injury group was divided into poor prognosis group with 25 cases and good prognosis group with 35 cases according to different postoperative prognosis. Serum Neuritin, NFL, S100B protein levels and clinical data differences between the two groups were analyzed, and multivariate Logistic regression analysis was performed to determine the relationship between the poor prognosis and various influencing factors in patients with spinal fracture complicated with SCI. Receiver operating characteristic (ROC) curves were used to determine the efficacy of the combination of serum Neuritin, NFL and S100B protein levels in predicting poor prognosis in patients with spinal fracture complicated with SCI. Results: Serum Neuritin, NFL and S100B protein levels in injury group and non-injury group were significantly higher than those in control group, and the above three serological indexes levels in injury group were higher than those in non-injury group (all P < 0.05). The spinal tract invasion rate in poor prognosis group was higher than that in good prognosis group, and the serum Neuritin, NFL and S100B protein levels were higher than those in good prognosis group (all P < 0.05). Multivariate Logistic regression analysis showed that spinal tract invasion rate and high Neuroitin, NFL and S100B protein levels were the risk factors of poor prognosis in patients with spinal fracture complicated with SCI (P＜0.05). The area under the curve, sensitivity, specificity and Youden index of combined detection of serum Neuritin, NFL and S100B protein levels in predicting poor prognosis in patients with spinal fracture complicated with SCI were higher than those of the above three indexes alone. Conclusions: Serum Neuritin, NFL, S100B protein levels were higher in patients with spinal fracture complicated with SCI, and the risk of poor prognosis is higher with the increase of the above three serological indexes levels. |
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