退变性腰椎管狭窄中小关节源性炎性因子作用的初步探讨  

Preliminary study on lumbar facet joint derived inflammatory factors in degenerative lumbar spinal canal stenosis

作　　者：陈海[1] 龚凯[1] 罗卓荆[1] 王哲[1] 杜俊杰[1] 黄明[1] 绍为[1] 

机构地区：[1]第四军医大学西京医院骨科研究所,西安710032

出　　处：《中国矫形外科杂志》2010年第7期543-547,共5页Orthopedic Journal of China

摘　　要：[目的]初步探讨小关节源性炎性因子在退变性腰椎管狭窄的作用。[方法]选取本科接受后路手术的退变性腰椎管狭窄(41例)及腰椎间盘突出患者(34例)共75例,采用Weishaup的分级标准评估小关节退变程度,记录术前腰腿痛、下肢痛及功能障碍评分。收集术中切除的一侧腰椎小关节标本;酶联免疫吸附剂测定法(enzyme-linked immunosobnent assay,ELISA)测定腰椎小关节退变关节软骨中白细胞介素1β(interleukin-1β,IL-1β)及肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)含量。[结果]TNF-α各组测量均为阴性结果。退变性腰椎管狭窄组IL-1β阳性率高于腰椎间盘突出组。IL-1β含量与腰椎小关节退变程度呈正比,随退变程度增加而升高。退变性腰椎管狭窄组中IL-1β阳性患者腰背痛、下肢痛及功能障碍评分均高于IL-1β阴性患者,而腰椎间盘突出组内则无明显差异。[结论]退变性腰椎小关节软骨产生IL-1β增加;小关节源性炎性因子可能是导致退变性腰椎管狭窄患者腰背痛、下肢痛及功能障碍的原因之一。[Objective]To initially approach the role of lumbar facet joint derived inflammatory factors in degenerative lumbar spinal canal stenosis. [Methods]Totally 75 cases of degenerative lumbar spinal canal stenosis（LSCS）（n=41）and lumbar intervertebral disc herniation（LDH）（n=34） undergoing posterior lumbar spinal surgery in our department were evaluated in terms of the extent of degenerative arthrosis according to the Weishaup grading criteria.The grading of backleg pain,melosalgia and functional impairment were recorded.The excised lumbar facet joints were collected as species.The content of interleukin-1β and tumor necrosis factor-α in the species were determined by ELISA.[Results]There was no TNF-α detected in both of the two groups.More IL-1β was detected in degenerative lumbar spinal canal stenosis group than that in lumbar intervertebral disc herniation group.It was demonstrated that the content of IL-1β in the species increased as the degeneration of lumbar facet joint sharpened.IL-1β-positive cases in degenerative lumbar spinal canal stenosis group showed higher grading of backleg pain,melosalgia and functional impairment.[Conclusion]The cartilage of degenerative lumbar spinal canal produced more IL-1β.Lumbar facet joint derived inflammatory factors might be one of the reasons that cause backleg pain and melosalgia and functional impairment in degenerative lumbar spinal canal stenosis patients.

关 键 词：退变性椎管狭窄 白细胞介素1Β 肿瘤坏死因子Α 

分 类 号：R681.5[医药卫生—骨科学]