腰椎间盘退变的分子病理学变化及发病机制

背景：腰椎间盘退变是引起腰腿痛的常见原因，椎间盘退变的病理改变及发病机制至今仍未完全明确。 目的：介绍腰椎间盘退变的分子病理改变及其发病机制的研究进展。 方法：以“disc histology，disc degenerative disease，disc gene”等主题词检索PubMed数据库，检索时间为2005/2010年，筛选与腰椎间盘组织学变化和发病机制相关的文献，总结归纳腰椎间盘退变的研究进展和研究结果。 结果与结论：共检索到与腰椎间盘退变有关的文章118篇，共纳入30篇。结果表明腰椎间盘退变受多种因素影响，包括基因遗传因素、自然老化和积累性损伤等，基因的多形性是诱发退变的重要前置因素。椎间盘退变可通过免疫反应、机械性压迫或不稳定、血循环障碍和炎性递质等因素导致椎间盘退变性疾病。老化和病理性退变在影像和病理上难以区别，应根据椎间盘退变性疾病的具体情况采取合理的治疗方法，生物学治疗提供了新的治疗思路，但目前仍处在实验研究阶段。

Molecular pathological changes and pathogenesis of lumbar disc degeneration

BACKGROUND:The lumbar disc degeneration is a common reason of low back pain. Pathological changes and pathogenesis of lumbar disc degeneration, but has not yet entirely clear. OBJECTIVE:To introduce the research progress on molecular pathological changes and pathogenesis of lumbar disc degeneration. METHODS:Taking “disc histology, disc degenerative disease, disc gene” as search terms, PubMed database was retrieved from 2005 to 2010. Literature about the histological changes and pathogenesis of lumbar disc degeneration was screened. Research progress and results of lumbar disc degeneration were summarized and generalized. RESULTS AND CONCLUSION:A total of 118 literatures related to lumbar disc degeneration were retrieved and 30 of them were included. The results showed that the lumbar disc degeneration is influenced by many factors, including gene hereditary factors, natural aging, accumulative injuries, etc. Gene polymorphism is an important prepositive factor of induced degeneration. Intervertebral disc degeneration can induce degenerative disc disease (DDD) by immunological reaction, mechanical compression or instability, blood circulation disorders, inflammatory mediators and other factors. It is difficult to differentiate aging and degeneration on imageology and pathology, so the reasonable treatment should be adopted according to specific circumstances of DDD. Biological therapy provides a new treatment idea, but research is still in experimental stage.