胶原酶对山羊硬膜外移植自体椎间盘组织溶解作用的观察  

Chemonucleolysis of epidural injected collagenase on autografts of intervertebral disc tissue in sheep lumbar spinal canal in vivo

作　　者：李振宙[1] 侯树勋[1] 刘茜[2] 商卫林[1] 吴闻文[1] 吴叶[1] 

机构地区：[1]解放军总医院第一附属医院骨科,北京市100037 [2]解放军总医院第一附属医院病理科,北京市100037

出　　处：《中国脊柱脊髓杂志》2007年第11期862-864,I0002,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的:观察椎管内硬膜外腔注射胶原酶对山羊腰椎管内移植的自体椎间盘组织的溶解作用。方法:9只成年山羊,经腰椎后路右侧L6/7、左侧L3/4椎板间隙移植自体椎间盘组织于椎管内神经根腋部,随机选择向2个间隙移植物周围灌注胶原酶300U/0.3ml或生理盐水0.3ml。分别于术后1d、1周、2周处死动物,观察胶原酶灌注后椎管内移植的椎间盘组织的组织学变化情况。结果:灌注胶原酶1d时髓核组织基质明显溶解,1周时出现大量巨噬细胞浸润,髓核结构明显破坏,2周时被肉芽组织替代;而灌注生理盐水1d时髓核组织无明显变化,1周时髓核组织中出现大量淋巴细胞浸润,2周时出现纤维母细胞、成纤维细胞和巨噬细胞浸润。胶原酶对纤维环的溶解作用不明显。结论:硬膜外腔注射胶原酶能直接溶解椎管内髓核组织,并能激发机体炎症反应过程,加速髓核组织的破坏和吸收。Objective：To study the chemonucleolysis of epidural injected collagenase on autografts of intervertebral disc tissue in sheep lumbar spinal canal in vivo.nethocl：9 adult goats were randomly assigned into 3 groups：1 day group,1 week group,2 weeks group.Autografts of intervertebral disc tissue was transplanted into lumbar spinal canal through interspaces between left L3/4 lamina and right L6/7 lamina.Collagenase （300U/0.3ml） or saline（0.3ml） was randomly epidural injected into lumbar spinal canal and infiltrated around autografts.Histological changes of autografts were studied.Result：Autografts of nucleus pulposus infiltraed with collagenase were dissolved significantly 1 day after injection,infiltrated with lots of macrophagocytes after 1 week and with structure of nucleus pulposus destroyed,replaced by granulation tissue after 2 weeks.While autografts of nucleus pulposus infiltrated with saline didn＇t show significant changes 1 day after injection,lots of lymphocytes infiltration was found after 1 week,fibroblasts and macrophagocytes infiltration was found after 2 weeks.Annular fibrosus showed only minimal dissolvation on the edge of autografts by collagenase.Conclusion： Epidural injected collagenase can directly dissolve nucleus pulposus tissue and stimulate inflammatory response to accelerate disorganization and absorption of nucleus pnlposns tissue.

关 键 词：胶原酶 椎间盘 化学髓核溶解术 组织学 山羊 

分 类 号：R453[医药卫生—治疗学] R681.5[医药卫生—临床医学]