急性脊髓损伤患者血清中单核趋化蛋白-1表达的意义

背景近年来国内外学者发现趋化性细胞因子可能参与了外周血细胞向损伤脊髓组织的募集.单核细胞趋化蛋白-1(MCP-1)属CC型趋化因子亚家族,对单核/巨噬细胞有较特异性的趋化作用.目的观察急性不完全脊髓损伤患者血清中MCP-1的表达,探讨继发性脊髓损伤的可能机制.设计以患者和健康者为研究对象,非随机化同期对照,探索性研究.单位一所大学医院的骨科.对象来源于武汉大学人民医院骨科2001-01/2002-12收治的急性不完全脊髓损伤患者8例和单纯椎体压缩骨折患者8例,另选健康者8例做对照.方法患者入院次日清晨空腹抽取外周静脉血8～10mL,静置,离心取血清.ELISA方法检测其中MCP-1的水平.健康者于检查日晨空腹抽血,程序同患者组.主要观察指标各组血清中MCP-1的浓度.结果健康对照、单纯椎体压缩骨折及急性不完全脊髓损伤组患者血清中MCP-1的浓度分别为(124±15),(184±21),(428±11)ng/L,组间比较差异有非常显著性意义(P＜0.01).结论MCP-1可能通过向脊髓损伤部位募集炎症细胞而参与脊髓损伤部位的继发性炎症反应.

Significance of serum monocyte chemoattractant protein-1 expression in patients with acute spinal cord injury

BACKGROUND: Studies in recent years have suggested the involvement of chemoattractant cytokines in the recruitment of peripheral blood cells to the injured spinal tissue. Monocyte chemoattractant protein-1(MCP-1) belongs to the CC-type chemokines and is capable of specific chemotactic attraction of the macrophages.OBJECTIVE: To observe MCP-1 expression in the serum of patients with acute spinal cord injury and explore the possible mechanism of secondary spinal cord injury.DESIGN: A non-randomized and controlled concurrent pilot study.SETTING and PARTICIPANTS: Eight patients with acute incomplete spinal cord injury and 8 with compression fracture of the spine were treated in the Department of Orthopaedics, Renmin Hospital of Wuhan University during the period from January 2001 to December 2002. Another 8 healthy subjects were included as the controls.METHODS: In the next morning after hospitalization, totally(8-10) mL of fasting peripheral venous blood was collected from the patients and the serum separated for determination of MCP-1 level with enzyme-linked immunosorbent assay(ELISA) . Serum MCP-1 level was also measured in the healthy subjects in the same manner.MAIN OUTCOME MEASURES: Serum level of MCP-1 in each group.RESULTS: Serum levels of MCP-1 in the healthy subjects, patients with compression fracture of the spine and those with acute incomplete spinal cord injury were(124 ± 15), (184 ±21) and(428 ± 11) ng/L, respectively, with significant differences between any two groups( P ＜ 0.01 ).CONCLUSION: MCP-1 may induce secondary inflammation by recruiting inflamnatory cells to the injury site and thus aggravate the spinal cord injury.