PDGF-BB与脊柱黄韧带增生肥厚致腰椎管狭窄的相关性研究

目的：探讨血小板衍生生长因子-BB（PDGF-BB）在腰椎黄韧带中的表达与黄韧带增生肥厚致腰椎管狭窄的相关性。方法：10例黄韧带增生肥厚腰椎管狭窄者为LSS组，10例腰椎间盘突出症者为LDH组，术前采用腰椎核磁共振的T1轴住加权像，经腰椎关节突平面定位，精确测量两组黄韧带厚度：分别采用实时定量聚合酶链式反应（Real-timePCR）法、免疫印迹法（WesternBlot）对比检测正常黄韧带与增生肥厚黄韧带腹侧、增生肥厚黄韧带背侧PDGF—BBmRNA和PDGF-BB蛋白表达的差异。结果：LSS组黄韧带显著厚于LDH组（P〈0．05）；增生肥厚黄韧带内部纤维化程度明显高于正常黄韧带（P〈0．05），PDGF-BB主要在增生肥厚黄韧带背侧呈显著表达；退变增生肥厚黄韧带背侧PDGF-BBmRNA表达显著高于正常黄韧带（P〈0．05）：退变增生肥厚黄韧带背侧PDGF-BB蛋白表达显著高于正常黄韧带（P〈0．05）。结论：PDGF-BB在增生肥厚黄韧带内背侧过度表达是引起脊柱黄韧带增生肥厚的主要原因，并导致腰椎管狭窄症。

A Correlation Study on Over-expression of PDGF-BB and Degenerative Hypertrophied Ligamentum Flavum

Objective： To investigate the role of platelet derived growth factor-BB （PDGF-BB） in degeneration of the hypertrophied ligamentum fla- vum （LF） in the lumbar spine. Methods： The degenerative hypertrophied LF was obtained during surgery from 10 patients with lumbar spinal steno- sis, and 10 patients with lumbar disc herniation were included as normal controls. The thickness of the LF was measured by axial Tl-weighted mag- netic resonance images at the facet joint level preoperatively. The mRNA expressions of PDGF-BB in the LF were detected using real time poly- merase chain reaction. The protein expression of PDGF-BB were investigated by Western blotting. Results： The thickness of the LF were 4.95 ± 1.13mm in degenerative group and 2.91±1.46 mm in control group, showing significant difference between the two groups （P〈0.05）. There was no significant difference between two groups of the mean age （P〉0.05）. The mRNA and protein expressions of PDGF-BB were significantly higher in the degenerative group than in the control group （P〈0.05）. Conclusion： Degenerative LF shows hypertrophy and fibrosis, and over-expression of PDGF-BB may be associated with in the development and progression of LF degeneration in the lumbar spinal stenosis.