不同Pfirrmann分级椎间盘内髓核细胞生物学特性的比较

目的比较不同Pfirrmann分级椎间盘内髓核细胞的生物学特性,验证腰椎间盘退变Pfirrmann分级能否反应髓核组织在细胞水平的退变程度。方法取术中获得的患者的髓核组织,按腰椎椎间盘退变Pfirrmann分级标准进行分组。组织切片甲苯胺蓝观察比较各组髓核内细胞的密度。采用酶消化法分离培养髓核细胞。台盼蓝染色计算各组细胞活性比率,光镜观察细胞形态,透射电镜观察细胞的超微结构。MTT法绘制各组2代细胞的生长曲线。阿利辛蓝法检测各组细胞的蛋白聚糖含量,比较各组差异。结果随退变级别升高,标本内胶冻样物质含量减少,透明度降低,纤维化组织增多,Ⅴ级标本完全纤维化,并伴有钙化,无法区分髓核组织。Ⅰ级和Ⅱ级髓核内细胞密度明显高于Ⅲ级,Ⅳ级又明显高于Ⅳ级。Ⅰ级组髓核细胞的活性比率为（93.5±3.7）%;Ⅱ级组细胞活性比率为（91.6±4.3）%;Ⅲ级组细胞活性比率为（83.5±6.7）%;Ⅳ级组细胞活性比率为（74.8±5.9）%。除Ⅰ级与Ⅱ级比较差异无统计学意义外,其余各组两两比较差异均具有统计学意义（P〈0.05）。光镜下Ⅰ级和Ⅱ级组细胞呈短梭形或多角形轮廓清晰饱满,折光性强。Ⅲ级组胞突较长,Ⅳ级组胞突更长,细胞轮廓模糊。电镜下Ⅰ级和Ⅱ级组细胞相似,胞浆内含有大量粗面内质网和线粒体,Ⅲ级组细胞内的粗面内质网和线粒体减少,出现小的空泡,可见溶酶体出现。Ⅳ级组细胞溶酶体大量聚集,可见巨大的空泡样结构。Ⅰ级组和Ⅱ级组细胞生长速率快于Ⅲ级组（P〈0.01））。Ⅲ级组细胞生长速率快于Ⅳ级组（P〈0.05）。Ⅰ、Ⅱ、Ⅲ、Ⅳ组细胞GAG含量分别为（423.19±41.21）mg/L,（408.23±29.25）mg/L、（273.05±52.44）mg/L、（91.73±38.06）mg/L,Ⅰ级组和Ⅱ级组细胞高于于III级组（P〈0.05））。Ⅲ级组细胞高于Ⅳ级组（P〈0.05）。结论椎间盘退变的Pfirrmann分级,能很好的反映髓核组织在细胞水平的退变程度。是一种简单有效的退变分级系统。

Biological characteristics of nucleus pulposus cells in intervertebral discs at different Pfirrmann grades

Objective To compare the biological characteristics of nucleus pulposus cells in intervertebral discs at different grades of Pfirrmann grading system in order to determine whether the system can reflex cell degeneration.Methods Human nucleus pulposus cells were isolated by collagenase digestion and primarily cultured.Then the cells were grouped based on the Pfirrmann grading system.Tissue sections were dyed by Toluidine blue to observe the cell density.Cell vitality assay was done with Trypan blue staining....