摘要
背景:腰椎间盘突出的过程不仅表现为形态学上的变化,同时也伴随有椎间盘的组织学与生化性质的一系列改变,细胞因子在椎间盘退行性变的病理过程中及由此所引起的临床症状中可能发挥着重要的调控作用。目的:分析腰椎间盘突出类型与肿瘤坏死因子α产生之间的关系。设计、时间及地点:试验于2005-03/10在河北医科大学第三医院骨科研究所完成。对象:选择河北医科大学附属第三医院脊柱科及小儿骨科收治的经手术证实腰椎间盘突出患者之髓核纤维环和邻近突出髓核的组织,共51例作为实验组,其中纤维环完整者即膨出者16例,突出者21例,脱出者14例。对照组标本取自本科和小儿骨科共7例患者15个间盘组织。方法:手术摘除椎间盘标本制作石蜡切片,采用免疫组织化学染色法对实验组和对照组标本进行测定。主要观察指标:各组标本肿瘤坏死因子α的水平。结果:对照组中未检测到肿瘤坏死因子α,而实验组中各标本均可检测到,两者相比,差异有显著性意义(P<0.01);实验组纤维环突出者及脱出间盘样本中肿瘤坏死因子α水平分别为66.7%和78.5%,与纤维环完整者25%相比,差异有显著性意义(P<0.05);纤维环完整者和突出及脱出者组织化学积分分别为1.00,5.76分和8.28分,3者相比,差异有显著性意义(P<0.05)。结论:腰椎间盘突出程度及纤维环撕裂程度越重时肿瘤坏死因子α的产生越多。
BACKGROUND： Lumbar intervertebral disc herniation （LIDH） comprises the morphological changes and a series of histological and biochemical changes of intervertebral disc. Cytokines may play a regulatory role on the pathogenesis of intervertebral disc degeneration and the clinical symptoms produced by herniated discs. OBJECTIVE： To analyze the correlation of herniated morphology with the production of tumor necrosis factor a （TNF- α ）. DESIGN, TIME AND SETTING： The experiments were performed at the Orthopaedics Institute in the Third Hospital of Hebei Medical University （Shijiazhuang, Hebei, China） from March to October in 2005. PARTICIPANTS： Fifty-one LIDH patients were enrolled from the Department of Pediatric Orthopaedics and Department of Spine in the Third Hospital of Hebei Medical University. They were lesioned in annulus fibrosus and adjacent nucleus pulposus prolapse tissues. LIDH types included bulging （intact anulus） in 16 cases, extrusion in 21 cases and sequestration in 14 cases. Control group comprised 7 patients （15 intervertebral disc tissues） from the same unit. METHODS： Intervertebral disc tissues were excised surgically and then prepared into paraffin section. All specimens were examined using immunohistochemistry. MAIN OUTCOME MEASURES： The production of TNF- α in each group was detected. RESULTS： TNF- α was not detected in the control group. But it was the opposite in the herniated groups. There was a statistically significant difference between the two groups （P 〈 0.01）; The production of TNF- α in patients with intervertebral disc extrusion or sequestration showed significant differences compared to that in patients with intervertebral disc bulging （66.7%, 78.5%, 25%, P 〈 0.05）; Significant differences were also found in the histochemistry between intervertebral disc extrusion or sequestration group and intervertebral disc bulging group （1.00, 5.76, 8.28, P 〈 0.05）. CONCLUSION： The greater degree of the LIDH and the anulus ruptured indicate the increasing production of TNF- α.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第33期6462-6465,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
