摘要
作者既往临床研究的结果表明，腰椎间盘突出症病人的神经根受压程度与临床症状和腰腿疼痛的程度并无直接关系。手术中病理观察发现，神经根有炎症表现者，在临床上表现出剧烈的根性疼痛，这似乎提示神经根性疼痛与局部的炎症有密切关系。磷脂酶（ＰＬ）Ａ２是人体内重要的炎症介质和致痛物质，也是组织炎症的标志物。作者采用生化方法测定了２０例腰椎间盘突出症病人手术中获取的髓核组织中的ＰＬＡ２活性水平，并将其结果与病人的神经根性疼痛程度和术中病理所见进行对照研究。研究结果表明：（１）腰椎间盘突出症病人椎间盘髓核中ＰＬＡ２活性显著高于自身血液中和健康人椎间盘髓核中ＰＬＡ２活性水平；（２）腰椎间盘突出症病人的腰腿痛程度与其髓核中ＰＬＡ２活性明显相关；（３）直腿抬高试验强阳性者的髓核中ＰＬＡ２活性水平显著增高；（４）腰椎间盘突出的类型与其髓核中ＰＬＡ２活性无显著关系。作者还就ＰＬＡ２在腰椎间盘突出症所引起的放射性疼痛中的作用进行了讨论。
The previous study by the authors revealed that the severity of low back and leg pain may not correlate to the size of disc herniation and in intra-operative .observations on several hundreds surgery confirmed that those patients with inflammation in their lumbar nerve rcots suffered froin severe radiculopathy. These phenomena seems to suggest that there could be a close pathogenetic relation between the radiculopathy and the inflammation of intracanal neural elements in lumbar disc herniation-In this study,the PL A2 activity was assayed in 20 disc samples removed at surgery for painful disc,and the correlation between the PL A2 activity in herniated discs and the severity of radiculopathy and the size of disc herniation was also investigated. The results could be concluded as follows: (1 )the level of PL A2 activity in herniated discs was much higher than it in blood and normal discs; (2)the severity of radicular pain significantly correlated to the level of PL A2 activity; (3)a higher level of PL A2 activity was found in the patients with obviously positive SLR test;(4)the size of disc herniation did not correlate to the PL A2 activity. The pathogenesis of radiculopathy was also discussed.Author′s address Department of Orthopedics,The 304th Hospital of PLA,Beijing, 100037
出处
《中国脊柱脊髓杂志》
CSCD
1996年第1期2-6,共5页
Chinese Journal of Spine and Spinal Cord
