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目的:探讨0期诊断技术对军事训练所致椎间盘源性下腰痛患者血清白介素1β(IL-1β)、6酮前列腺素F1α(6-keto-PGF1α)、肿瘤坏死因子α(TNF-α)水平的影响及其意义。方法:随机抽取某部2014年度新兵一营306名新兵为实验组,新兵二营290名新兵为对照组,在入伍复检时为每名士兵抽血检测相关血清学指标,并建立健康档案。由经过技术培训的医师对实验组采用0期诊断技术,分别在新兵训练开始后的第2、4、6、8、10、12周进行0期椎间盘源性下腰痛的筛查,并实施相应的防治措施,同时,按照“军标”对所有实验对象进行下腰痛的常规诊治及登统计,对于诊断为0期椎间盘源性下腰痛阳性和椎间盘源性下腰痛阳性的士兵及时抽血检测IL-1β、6-keto-PGF1α、TNF-α血清值。结果:实验组椎间盘源性下腰痛总发生率(2.94%)明显低于对照组(9.66%)(x~2=11.527,P<0.001)。在新训开始后的第8、10、12周,实验组椎间盘源性下腰痛的发生率均明显低于对照组(P<0.05);实验组和对照组阳性士兵血清IL-1β、6-keto-PGF1α、TNF-α水平比较无差异,0期阳性和阳性士兵血清IL-1β、6-keto-PGF1α、TNF-α水平与训练前相比均明显升高(P<0.05),0期阳性士兵血清IL-1β、6-keto-PGF1α、TNF-α值均明显低于本组和对照组阳性士兵(P<0.05)。结论:0期诊断技术预防军事训练所致新兵椎间盘源性下腰痛的效果明显,通过监测IL-1β、6-keto-PGF1α、TNF-α血清的水平变化也进一步证实0期诊断技术用于预防军事训练所致椎间盘源性下腰痛的可行性。
OBJECTIVE: To investigate the clinical significance of 0-phase diagnostic technique for detecting the levels of serum IL-1β, 6-keto-PGF1α and TNF-α in military patients with discogenic low back pain. Influence and Significance. Methods: A total of 306 recruits from the First Recruit Battalion in 2014 were selected as the experimental group and 290 new recruits from the Second Battalion in the Second Battalion as the control group. Blood samples were collected for serotonin-related serological tests and health records were established for each soldier during the re-examination. The technicians trained by the technicians used the 0-phase diagnostic technique to the experimental group to carry out the 0 stage screening of lumbar discogenic low back pain on the 2nd, 4th, 6th, 8th, 10th and 12th week after the recruits training, At the same time, according to the “military standard” for all subjects of low back pain routine diagnosis and treatment of statistics, for the diagnosis of 0-stage lumbar disc herniation and disc-positive low back pain positive soldiers timely blood Serum IL-1β, 6-keto-PGF1α and TNF-α were detected. Results: The total incidence of lumbar discogenic low back pain (2.94%) in the experimental group was significantly lower than that in the control group (9.66%) (x ~ 2 = 11.527, P <0.001). The incidence of lumbar discogenic low back pain in the experimental group was significantly lower than that in the control group at the 8th, 10th and 12th week after the start of the new training (P <0.05). The serum IL-1β, 6- The levels of IL-1β, 6-keto-PGF1α and TNF-α in serum of 0-positive and -positive soldiers were significantly higher than those of before training (P <0.05) The serum levels of IL-1β, 6-keto-PGF1α and TNF-α in the positive soldiers were significantly lower than those in the control group (P <0.05). Conclusion: 0-phase diagnostic technique is effective in preventing recurrent discogenic low back pain caused by military training. It is further confirmed that the 0-phase diagnostic technique is used for prevention by monitoring the changes of serum levels of IL-1β, 6-keto-PGF1α and TNF-α Feasibility of military training for discogenic low back pain.