摘要
【目的】探讨腰椎失稳对腰椎间盘、关节突关节组织、黄韧带内炎性因子和炎性细胞浓度的影响。【方法】根据纳入及排除标准,自2010年1月-2011年7月间收集我院行腰椎融合术的退变性腰椎失稳症患者40例,术中分别切取失稳节段与邻近正常节段椎间盘组织、关节突关节组织、黄韧带组织,采用ELISA法分别比较两组标本的IL-1β、IL-6、TNF-α的浓度;采用高倍镜下计数法比较两组标本中CD20、CD45、CD68标记的阳性细胞数。【结果】失稳节段与邻近正常节段比较:IL-1β、IL-6、TNF-α3种因子在椎间盘及关节突关节组织中的含量比较具有统计学差异(P<0.05);在黄韧带组织中;IL-1β浓度在两组中差别有统计学意义,IL-6、TNF-α的差别无统计学意义(P>0.05)。失稳节段的B细胞CD20、T细胞CD45、巨噬细胞CD68在椎间盘及关节突关节组织中的阳性细胞数高于临近节段(P<0.05),而在黄韧带组织中三种细胞的阳性数量无统计差别。【结论】腰椎失稳造成的脊柱异常应力的增加,引起三关节复合体及韧带组织创伤性炎性反应,导致椎间盘和关节突组织的炎症细胞和炎性因子的聚集。局部炎症因子的增加会导致腰痛,并进一步破坏椎间盘及关节,增加腰椎不稳,成为腰椎失稳性疼痛的只要致病原因。
[Objective] To investigate the effect of lumbar instability on inflammatory cell infiltration and inflammatory factors distrabution in lumbar intervertebral disc, ligamentum flavum and facet joints [ Methods ] 40 patients with pain due to lumbar instability were included in this study from JAN.2010 to JUL.2011 from Tianjin Union Medicine Center. Specimens of discs, ligamcntum flavum, and facet joints of lumbar instable segment and adjacent stable segment were obtained respectively during operation, the concentration of IL-113 , IL-6, TNF- α were tested ,the number of inflammatory cells were counted and compared through immunobistochemistry method [ Rusults] The concentration of IL-1β, IL-6,TNF- α are higher in lumbar intervetebral disc, ligamentum flavum and facet joints in patients with lumbar instability than adjacent non-stable segment. While there is no difference between the concentration of IL- 6 and that of TNF- α. The number of T cell,B cell Macrophage cell are more in lumbar intervetebral disc and facet joints except in the ligament flavum. [Conclusion ] The lumbar instability may cause more abnormal stress on three joints complexus ,which can lead to traumatic inflammatory effect, then the number of T cell ,B cell, Macrophage will increase, and the concentration of IL- 1β , IL-6, TNF- α will increase accordingly. This can further destroy the stability of lumbar spine, the lumbar instability may be one of the main reasons of degenerative low back pain.
出处
《武警后勤学院学报（医学版）》
CAS
2014年第9期729-732,共4页
Journal of Logistics University of PAP（Medical Sciences）
关键词
腰椎失稳
腰痛
炎性反应
Lumbar instability
Lumbar pain
Inflammatory reaction
