摘要
目的：探讨椎动脉外膜含肽能神经的分布特点，分析椎动脉外膜剥离术的疗效。方法：应用免疫组化ＡＢＣ法观察３８例新鲜尸体和１０例椎动脉型颈椎病患者椎动脉外膜上肽能神经（降钙素基因相关肽ＣＧＲＰ，血管活性肠肽ＶＩＰ，神经血管肽ＮＰＹ）的分布情况。对７９例确诊椎动脉型颈椎病和狭窄率超过１８％的患者进行了五种术式。结果：舒缩血管的含肽能神经主要分布在人椎动脉外膜，随年龄增加神经纤维密度增多，但增至４０岁以后，舒血管肽ＣＧＲＰ、ＶＩＰ能神经纤维密度减少，缩血管肽神经ＮＰＹ能神经纤维密度增多，椎动脉型颈椎病患者组改变更明显，差异有显著性（Ｐ＜０．０１）；术后随访表明椎动脉外膜剥离术疗效优于其它术式，优良率达９３．１８％。结论：手术治疗椎动脉型颈椎病时应在去除外源性机械压迫因素的同时去除神经因素，椎动脉外膜剥离术是有效术式。
Objective:The distribution and aging concerned with peptide containing nerve fibers(VIP, NPY, CGRP) were analyzed in human vertebral arterial adventitia in the normal and pathological state.The theoretical basis and clinical significance of the vertebral arterial adventitia decollement were studied.Methods:The distribution of peptide containing nerve fibers in 48 cases vertebral arterial adventitia were observed with sensitive immunohistochemistry (ABC).79 cases were operated by five kinds of operations and were diagnosed as vertebral arterial insufficiency type cervical spondylosis by computer automatic geometric and densitometric quantification to detect the stenosed segment>18% in DSA.Results:Peptide containing nerves were rich in human vertebral arterial adventitia,the density of all VIP, CGRP, NPY immunoreactive nerves kept rising before age of 40.The density of vasodilation VIP,CGRP immunoreactive nerves began to decrease and the NPY immunoreactive nerves for contrictive vessels continued to rise between age of 40￣60 especially in vertebral arterial insufficiency type cervical spondylosis. The results have statistical significance (P<0.01). Clinical results showed that vertebral arterial adventitia decollement had good effect than any other operations,and 93.18% had excellent and good results.Conclusions:The results suggeste that the nervous factors should be removed as well as the outside mechanical compression in the operation for the vertebral artery insufficiency type of cervical spondylosis. The vertebral arterial adventitia decollement is an effective way. Authors address\ Department of Orthopaedics,First Clinical Hospital,Xian Medical University,Xian,Shanxi,710061
出处
《中国脊柱脊髓杂志》
CAS
CSCD
1998年第1期6-9,共4页
Chinese Journal of Spine and Spinal Cord
基金
陕西省卫生厅科研基金
关键词
椎动脉
颈椎病
外膜剥离术
免疫组织化学
Vertebral artery\ Adventitia decollement\ Cervical spondylosis Immunohistochemistry
