腰椎融合术后血清IL-18的动态表达特点、影响因素及其临床意义-东南大学学报医学版

腰椎融合术后血清IL-18的动态表达特点、影响因素及其临床意义

单位：1. 南通大学附属建湖医院骨科, 江苏盐城 224700;
2. 南通大学附属医院脊柱外科, 江苏南通 226001

分类号：R687.3

出版年·卷·期（页码）：2018·37·第五期（887-891）

摘要：

目的：探讨白细胞介素-18（IL-18）在腰椎融合术后动态表达特点，分析其影响因素及临床意义。方法：纳入2015年1月至2016年6月期间行腰椎融合术的患者58例，术前及术后动态监测血清IL-18表达水平的变化，采用相关性分析探讨IL-18与其它常用炎症指标之间的相关性，并探讨影响其表达的相关临床参数。结果：与其它炎症指标相比，IL-18表达在术后最早（术后1 d）达到高峰，且与其它几项炎症指标表达均呈正相关。与术后IL-18表达水平升高相关的主要因素为手术时间和术中失血量；此外，女性、高龄也与术后IL-18表达水平升高存在着相关性。结论：监测腰椎融合术后IL-18的表达可了解术后炎症反应情况，缩短手术时间、减少术中出血、对高龄患者加强抗感染处理，可能有助于减轻术后炎症反应、预防切口感染。

Objective:To investigate the characteristics of interleukin-18 (IL-18) expression in serum of patients underwent lumbar interbody fusion, and to explore the potential clinical significance.Methods:Between January 2015 to June 2016, 58 patients underwent posterior lumbar interbody fusion were enrolled. The expression levels of IL-18 and other inflammation markers were detected and compared at different time-points. Besides, the correlation analysis were conducted to certify the clinical value of IL-18 as an important inflammation marker, and to ensure the clinical parameters that may influence IL-18 expression. Results:IL-18 expression experienced a peak at 1 day postoperatively, which was fastest compared with other markers. Postoperatively, positive correlations were shown between IL-18 and other markers with statistically significance. The influence factors of IL-18 expression postoperatively were mainly operation time and intraoperative blood loss. Besides, female and older age may also promote IL-18 expression postoperatively. Conclusion:IL-18 is one of the important inflammation markers, it can be used as a potential indicator of incision infection at early stage post lumbar interbody fusion surgery. To remit postoperative inflammatory reaction, we should try to shorten operation time and operate more carefully to reduce blood loss. Also, anti-infection treatment should be strengthened in aged patients.

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