腰骶部背根神经的脉冲射频对细胞因子的影响

目的 观察腰骶部背根神经的脉冲射频对细胞因子TNF-、IL-1和IL-6的影响.探讨脉冲射频可能的机制.方法 对18例保守治疗无效的神经根性腰腿痛患者,在影像学引导下进行穿刺定位行背根神经脉冲射频治疗,在行背根神经的脉冲射频前24h（T0）,术毕后即时（T1）,术毕后6 h（T2）,术毕后24 h（T3）,术毕后4 h（T4）,术毕后72 h（T5）,分别抽取肘静脉血测定TNF-a、IL-1和IL-6浓度并对患者进行活动时视觉模拟尺度评分（VAS）评分.结果 与行背根神经的脉冲射频前24h比较,术毕后6 h（T2）,术毕后24 h（T3）,术毕后48 h（T4）,术毕后72 h（T5）的TNF-浓度逐渐下降（P＜0.05）,与T0比较T3、T4、T5IL-1和IL-6的浓度明显降低.与T0比较T1、T2、T3、T4、T5,（VAS）明显改善（P＜0.05）.结论 腰骶部背根神经脉冲射频通过降低细胞因子TNF-a、IL-1和IL-6的产生,对神经根性疼痛有治疗作用.

Effect of pulsed radiofrequency treatment of the lumbosacral dorsal root on cytokines

Objective ] To investigate the effect of pulsed radiofrequency treatment of the lumbosacral dorsal root on cytokines and to explore the potential mechanism of the pulsed radiofrequency. Methods] Eighteen patients with lumbosacral radicular pain treated with pulsed radiofrequency after conservative therapy were retrospectively evaluated. Blood samples were taken 24 h before pulsed radio-frequency, after operation, 6 h after operation, 24 h after operation, 48 h after operation, and 72 h after operation for determination of plasma levels of TNF-, IL-1, IL-6 activity. The ten-point VAS was used. Result] The plasma levels of TNF- at T2, T3, T4 and T5 were significantly lower after pulsed radiofrequency, compared to T0- The plasma levels of IL-1, IL-6 at T3, T4 and T5 were significantly lower after pulsed radiofrequency, compared to To. Conclusion] It suggests that the use of pulsed radiofrequency in the treatment of the lumbosacral radicular pain appears to be effective by inhibiting plasma TNF-a, IL-1, IL-6.