Serum oxidative stress influences neurological recovery after surgery to treat acutely worsening symptoms of compression myelopathy: a cross-sectional human study
Serum oxidative stress influences neurological recovery after surgery to treat acutely worsening symptoms of compression myelopathy: a cross-sectional human study
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DOI：
10.1186/s12891-019-2966-5
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发表时间：
2019-12-07
影响因子：
2.3
通讯作者：
Nakagawa, Koichi
中科院分区：
文献类型：
--
作者：
Takahashi, Hiroshi;Aoki, Yasuchika;Nakagawa, Koichi
背景最近的研究表明，活性氧诱导的氧化应激与神经退行性疾病的病理生物学有关，包括神经细胞凋亡。在这里，我们进行了一项横断面研究，以评估血清氧化应激水平的颈椎压迫性脊髓病。方法36例急性加重型脊髓压迫症（AM）和慢性脊髓压迫症（CM）患者术前采集血清样本。通过测量反映氢过氧化物浓度的活性氧代谢产物（ROM）的衍生物来评价氧化应激标志物的血清水平。健康个体的ROM范围为250至300（U。卡尔），而ROM >340-400和> 400分别定义中度和重度氧化应激水平。分析不同病因脊髓型颈椎病（CSM）和颈椎纵韧带骨化症（OPLL）患者ROM的差异，以及ROM与患者年龄、体重指数（BMI）、吸烟史、糖尿病的相关性。根据日本骨科协会（乔亚）评分进行神经系统评估，并与ROM。结果ROM增加到349.5 +/- 54.8，代表中度氧化应激，在CM样本。在AM样品中ROM增加到409.2 +/-77.9，反映了严重的氧化应激，其显著高于CM样品（p < 0.05）。疾病原因（CSM或OPLL）无显著差异。女性AM患者血清ROM显著高于AM男性和CM患者（p < 0.05）。ROM与年龄、BMI、吸烟史和糖尿病之间无相关性。在AM组中观察到ROM与乔亚评分恢复率呈负相关（R-2 = 0.454，p = 0.047）。结论虽然CM患者存在中度氧化应激，但AM患者的氧化应激水平严重程度增加。这些结果表明，术后神经功能的恢复受到严重的氧化应激在AM。
Background Recent reports indicate that oxidative stress induced by reactive oxygen species is associated with the pathobiology of neurodegenerative disorders that involve neuronal cell apoptosis. Here we conducted a cross-sectional study to evaluate serum levels of oxidative stress in cervical compression myelopathy. Methods Thirty-six serum samples were collected preoperatively from patients treated for acutely worsening compression myelopathy (AM) and chronic compression myelopathy (CM). Serum levels of oxidative stress markers were evaluated by measuring derivatives of reactive oxygen metabolites (ROM), which reflect concentrations of hydroperoxides. ROM in healthy individuals range from 250 to 300 (U. CARR), whereas ROM >340-400 and > 400 define moderate and severe levels of oxidative stress, respectively. Difference of ROM by the cause of disorders whether cervical spondylotic myelopathy (CSM) or cervical ossification of longitudinal ligament (OPLL), correlations between ROM and patient age, body mass index (BMI), history of smoking, existence of diabetes were examined. Neurological evaluations according to Japanese Orthopaedic Association (JOA) scores were performed and correlated with ROM. Results ROM increased to 349.5 +/- 54.8, representing a moderate oxidative stress, in CM samples. ROM increased to 409.2 +/- 77.9 in AM samples, reflecting severe oxidative stress which were significantly higher than for CM samples (p < 0.05). There was no significant difference by the cause of disorders (CSM or OPLL). ROM were significantly increased in AM serum samples from female patients versus AM male and CM patients (p < 0.05). There were no correlations between ROM and age, BMI, history of smoking, and existence of diabetes. A negative correlation between ROM and recovery rate of JOA score (R-2 = 0.454, p = 0.047) was observed in the AM group. Conclusions Although moderate oxidative stress was present in patients with CM, levels of oxidative stress increased in severity in patients with AM. These results suggest that postsurgical neurological recovery is influenced by severe oxidative stress in AM.