腰椎间盘突出症患者IgM和IgG与其症状和体征相关性研究

目的 探讨腰椎间盘突出症患者腰椎间盘中血管浸润和IgM、IgG分布,以及IgM、IgG与患者症状和体征之间的关系.方法 收集59例单节段腰椎间盘突出症患者的腰椎间盘标本,男36例,女23例;年龄(41±17)岁.发病部位:L2-3 1例,L3-4 4例,L4-5 35例,K5S119例.以2例正常腰椎间盘标本为对照.根据术中所示腰椎间盘的位置分为突出组和脱出组.术前检查患者视觉模拟评分(visual analogue scale,VAS)和直腿抬高试验.HE染色观察椎间盘标本中血管形成的特征,免疫组化法检测IgM、IgG分布,并测量光密度进行定量分析.结果 脱出组新生血管形成率(78.9%)高于突出组(17.5%).脱出组IgM阳性率(94.7%)高于突出组(60.0%),脱出组IgG阳性率(94.7%)高于突出组(47.5%),两者IgM、IgG阳性率比较,差异均无统计学意义.腰椎问盘IgG阳性患者的VAS(6.49±1.96)高于IgG阴性患者(4.80±3.39),两者比较差异有统计学意义;IgM阳性患者VAS(6.17±2.20)高于IgM阴性患者(5.09±3.59),两者比较差异无统计学意义.椎问盘有IgM、IgG沉积患者的VAS和椎间盘中IgM、IgG的积分光密度呈正相关.结论 腰椎间盘突出后出现新生血管和IgM、IgG沉积,IgM、IgG介导的免疫反应在患者症状和体征的发生、发展中起重要作用.

Clinical signs and symptoms relate to IgM and IgG in herniated lumbar intervertebral disc

Objective To study blood vessel ingrowth and distribution of IgM,IgG in herniated lumbar intervertebral disc.And to make clear the relationship between the severity of signs,symptoms and IgM,IgG.Methods Disc samples from 59 patients with single-level lumbar intervertebral disc herniation were collected,included 36 males an'd 23 females,with the age of 41±17 years.Two normal lumbar intervertebral discs were collected as control.The patients were grouped as extruded and protruded group according to the position of intervertebral disc which was observed in operation.Visual analogue scale(VAS)and straight leg raising test of the patients were recorded before operation.Angiogenesis in the intervertebral disc was detected by HE staining.The distribution of IgM and IgG in the intervertebral disc was detected by immunohistochemistry.Then photodensity was recorded to analyze the amount of IgM and IgG.Results There were more samples with angiogenesis in extruded group(78.9%)than protruded group (17.5%).There were more samples with IgM in extruded group (94.7%)than protruded group(60.0%).There were more samples with IgG in extruded group(94.7%)than protruded group(47.5%).VAS of the patient wih IgG in the intervertebral disc was higher(6.49±1.96) than that without(4.80±3.39).VAS related to the integral photodensitv of IgM and IgG.Conclusion Angiogenesis,IgM and IgG were detected in herniated lumbar intervertebral disc.IgM and IgG may play an important role in the development of patients'signs and svmptoms.