突出的颈椎间盘组织炎症反应机制研究(英文)

目的研究颈椎病发生中突出颈椎间盘组织的炎症反应机制及其在颈椎间盘退行性变和颈椎病发病中的作用。方法临床收集了31例脊髓型颈椎病患者的35个突出的颈椎间盘标本和3例成年人的7个正常颈椎间盘标本。将每个标本分为2份,1份作组织学检查,观察有无炎细胞浸润,1份用生物化学方法测定其中白细胞介素-1α(IL-1α),IL-6和肿瘤坏死因子(TNF-α)3种细胞因子含量。结果35例突出颈椎间盘中,18例(51%)在边缘区域有大量炎细胞浸润,其余17例(49%)未见炎细胞浸润,对照组也未见炎细胞浸润。生物化学测定结果表明,颈椎病组IL-1α,IL-6和TNF-α分别为(10.4±1.9),(7.7±2.1),(7.5±1.7)pg/g,有炎细胞浸润组分别为(10.6±2.2),(8.6±1.6),(8.0±1.6)pg/g,无炎细胞浸润组分别为(10.2±1.6),(6.7±2.6),(7.0±1.8)pg/g,对照组分别为(2.0±0.9),(1.2±1.0),(1.3±0.8)pg/g,3种细胞因子含量明显高于正常对照组(P=0.0001,t=11.3591,7.9510,9.3728)。炎细胞浸润组与无炎细胞浸润组3种细胞因子含量相当,差异无显著性意义(P>0.05,t=0.6120,2.6204,1.7394)。结论突出颈椎间盘组织具有炎症反应特性,并可能在颈椎间盘退行性变和颈椎病的发生发展中起重要作用。

Study on inflammatory mechanism of herniated cervical intervertebral discs from patients with cervical spondylotic myelopathy

Aim To study the inflammatory mechanism of herniatedcervical intervertebral discs from patients with cervical spondyloticmyelopathy, and the roles of the inflammation in the cervical disc degenera-tion and cervical spondylosis. Methods 35 herniated cervical discs wereobtained fron 31 patients with cervical spondylotic myeloyathy during theanterior cervical surgery. 7 normal, nondegenerated cervical discs(controlgroup) were obtained from three fresh cadavers. All discs were divided intotwo samples, one of which was used as histological examination, and theother was used to detect contents of IL-1α. IL-6 and TNF-α biochemi-cally. Results In 35 herniated cervical discs, 18(51% ) were shownabundant inflammatory cell infiltrates in margin of herniated discs; 17(49%) no inflammatory cell infiltrates; normal discs also no any inflam-matory cell infiltrates. Biochemical assay indicated IL-1 α, IL-6 and TNF-αin cervical spondylotic myelopathy was (10.4 ± 1.9), (7.7 ± 2. 1 ) and(7.5 ± 1.7) pg/g respectively and those in noninflammatory infiltrates groupwas (10.2 ± 1.6), (6.7 ± 2.6) and (7.0 ± 1.8) pg/g respectively and thosein the control group was (2.0±0.9), (1.2±1.0) and (1.3±0.8)pg/g.The contents of cytokine IL-1α, IL-6 and TNF-α were obviously higher thanthat of normal discs( P =0. 000 1, t = 11. 359 1, 7. 951 0, 9. 372 8), andthere were no differences in the contents of cytokines between discs withinflammatory cell infiltrates and discs with no inflammatory cell infiltrates(P＞ 0.05, t=0.6120, 2.6204, 1.7394).Conelusion Herniatedcervical disc from the cervical spondylotic myelopathy was inflammatory, andinflammation may play an important role in cervical disc degeneration and inpathogenesis of cervical spondylosis.