术前滑液细胞因子与镜下肩袖撕裂修复预后

Correlation between preoperative synovial cytokines and prognosis of arthroscopic repair for rotator cuff tear

摘要:

［目的］分析滑液生长素释放肽（ghrelin）和白细胞介素-1β（IL-1β）与肩袖撕裂伤（rotator cuff tear, RCT）患者关节镜治疗预后的关系。［方法］前瞻纳入医院 2019 年 6 月—2020 年 6 月接受关节镜治疗的 80 例 RCT 患者为研究对象，于术后 6 个月依据肩关节 Neer 评分，将患者分为预后良好组和不良组；采用单因素和二元多因素分析影像预后的因素。对术前滑液细胞因子检测结果判断预后行 ROC 分析。［结果］末次随访时按临床结果评定，将患者分为良好组 58 例，不良组 22 例。良好组的术前关节滑液 ghrelin 水平显著高于不良组，而 IL-1β 水平显著低于不良组（P<0.05）。末次随访时 80 例患者 Neer 评分与术前滑液 ghrelin 呈显著正相关（P<0.05），与术前滑液 IL-1β 呈显著负相关（P<0.05）。二元多因素逻辑回归分析表明，术前滑液 ghrelin 高表达是临床结果不良的保护因素（OR=0.276，P<0.05），而 IL-1β 高表达是临床结果不良的危险因素（OR=1.142，P< 0.05）。ROC 分析表明术前滑液 ghrelin、IL-1β 单一检测及联合均具有预测临床结果的价值。［结论］术前滑液细胞因子与镜下肩袖撕裂修复预后有关系。

Abstract:

[Objective] To explore the relationship between synovial cytokines, including ghrelin and interleukin-1β (IL-1β), and the prognosis of arthroscopic repair for rotator cuff tear (RCT) . [Methods] A total of 80 patients who underwent arthroscopic repair for RCT in the hospital were prospectively enrolled into this study from June 2019 to June 2020. Based on Neer score at 6 months postoperatively, the patients were divided into the good outcome group and poor outcome group. The preoperative factors impacted on the prognosis were searched by using univariate comparison and binary multivariate logistic regression. In addition, ROC analysis was performed on the preop- erative synovia cytokines and the outcomes. [Results] At the latest follow-up, 58 patients were divided into the good group, while the re- maining 22 patients fall in the poor group. The good group had significantly higher preoperative synovial ghrelin, while significantly lower synovial IL-1β than the poor group (P＜0.05) . The Neer scores at the latest follow-up in 80 patients was significantly positively correlated with preoperative synovial fluid ghrelin (P＜0.05) , whereas significantly negatively correlated with preoperative synovial fluid IL- 1β (P＜ 0.05) . As results of the binary multivariate logistic regression analysis, preoperative high expression of synovial ghrelin was a protective fac- tor for poor clinical outcome (OR=0.276, P＜0.05) , whereas the high expression of IL-1β was a risk factor for poor clinical outcome (OR= 1.142, P＜0.05) . In addition, the ROC analysis showed that preoperative synovial ghrelin, IL-1β detected individually and the combination had significant value of predicting poor clinical outcome. [Conclusion] The preoperative synovial cytokines might be meaningful indicators for judging the prognosis of RCT arthroscopic treatment.