腰椎间盘突出症经皮激光椎间盘减压术后患者血浆β-内啡肽和P物质的水平  

Efficacy of percutaneous laser disc decompression and its correlation with plasma levels of β-endorphine and substance P in patients with protrusion of lumbar intervertebral disc

作　　者：潘化平[1] 冯慧[1] 王健[1] 丁玉惠[1] 

机构地区：[1]东南大学医学院附属南京江北人民医院康复医学科,210048

出　　处：《中华全科医师杂志》2010年第8期540-543,共4页Chinese Journal of General Practitioners

基　　金：南京市医学科技发展基金（YKK06133）

摘　　要：目的 了解经皮激光椎间盘减压术对腰椎间盘突出症患者血浆中β-内啡肽和P物质的影响.方法 对78例腰椎间盘突出症患者分别采用经皮激光椎间盘减压术（40例,为观察组）、物理因子＋腰椎牵引治疗（38例,为对照组）.在治疗前,治疗后第1天、第1周及第4周,分别检测外周血浆中β-内啡肽和P物质的含量,评估患者治疗前后疼痛指数.结果 观察组与对照组治疗后第1天、第1周血浆P物质含量,分别为（186±66）与（419±82）ng/L、（127±83）与（322±47）ng/L,β-内啡肽为（313±27）与（187±56）mg/L、（364±18）与（211±39）mg/L,组间比较差异有统计学意义（P＜0.01）,临床有效率分别为90%（36/40）和66%（25/38）;治疗后第4周,血浆中P物质为（64±50）与（93±75）ng/L、β-内啡肽为（410±21）与（317±42）mg/L,差异有统计学意义（P＜0.01）,临床有效率分别为95%（38/40）和84%（32/38）.结论 经皮激光椎间盘减压术治疗可降低腰椎间盘突出症患者外周血浆中P物质含量,提高β-内啡肽含量,从而发挥镇痛作用;P物质与β-内啡肽检测可以作为疗效评价的参考指标.Objective To observe efficacy of percutaneous laser disc decompression （PLDD） and its correlation with plasma levels of β-endorphine and substance P in patients suffering from protrusion of lumbar intervertebral disc （PLIVD）. Methods Seventy-eight patients with PLIVD were randomly divided into two groups, one group （40 patients） treated with PLDD and the other （38 patients） treated with lumbar spine traction and physical therapy as control. Their peripheral plasma levels of β-endorphine and substance P were measured before the procedure and one day, one week and four weeks after it, respectively.Meanwhile, the visual analogue scale （VAS）was applied to assess their pain index. Results Plasma level of substance P was （186±66） ng/L and （419±82） ng/L, and （127 ＋83） ng/L and （322 ＋47） ng/L,in treatment and control groups, one day and one week after the procedure, respectively, and that of β-endorphine was （313 ±27） mg/L and （187 ±56） mg/L, and （364 ＋ 18） mg/L and （211 ＋39） mg/L,one day and one week after it, respectively （ all P 〈 0. 01 ）, with its clinical efficacy of 90% （36/40）and 66% （25/38） one week after it, respectively （ P 〈 0. 01 ） . Four weeks after it, plasma level of substance P was （64 ±50） ng/L in treatment group as compare to that in controls （93 ±75） ng/L, and that of β-endorphine was （410 ± 21 ） mg/L and （317 ± 42 ） mg/L, respectively, with efficacy of 95% （38/40） and 84% （32/38）, respectively. Conclusions Plasma level of substance P can be reduced and that of β-endorphine can be increased by PLDD in patients with PLIVD, thus relieving their pain.Measurements of substance P and β-endorphine can be used as objective indicators to evaluate clinical efficacy of PLDD.

关 键 词：激光手术 腰椎 椎间盘移位 Β内啡肽 P物质 

分 类 号：R687.3[医药卫生—骨科学]