腰椎退变黄韧带中炎性细胞因子的表达  

The expression of inflammatory cytokines in ligamentum flavum of the degenerative lumbar and its clinical significance

作　　者：李强[1] 赵建民[1] 张元智[1] 刘聪[2] 

机构地区：[1]内蒙古医学院第一附属医院骨科 [2]内蒙古医学院外科学系,内蒙古呼和浩特市010050

出　　处：《中国脊柱脊髓杂志》2011年第1期63-66,共4页Chinese Journal of Spine and Spinal Cord

基　　金：内蒙古自治区自然科学基金资助项目(编号:200408020928)

摘　　要：目的:观察腰椎退变黄韧带中炎性细胞因子的表达情况,探讨其在腰椎黄韧带退变过程中的作用。方法:收集腰椎退变性疾病患者在后路椎板切除减压治疗时取下的黄韧带标本40例(退变组),术前通过CT、MRI证实均有黄韧带肥厚;以10例脊柱外伤行后路手术治疗的青年患者的腰椎黄韧带作为对照(对照组)。将术中切除的黄韧带剔除骨、脂肪及筋膜等组织,修成约2cm×1.5cm×0.3cm,在10%福尔马林溶液中固定24～48h后取出,制备成石蜡切片,采用苏木精伊红(HE)染色,应用光学显微镜观察病理学改变,并用免疫组化技术观察黄韧带标本中白介素-1(IL-1)、IL-6和肿瘤坏死因子-ɑ(TNF-ɑ)的表达情况。结果:对照组黄韧带弹力纤维呈波浪状,排列规则,弹力纤维间可见少量的胶原纤维和散在的成纤维细胞(22.56±6.05个/HP);退变组黄韧带弹力纤维明显减少,胶原纤维增多,并且伴软骨细胞、成纤维细胞、毛细血管的增生,成纤维细胞计数为62.66±18.40个/HP,两组成纤维细胞计数差异有统计学意义(P<0.05)。退变黄韧带组织中IL-1、IL-6、TNF-α表达阳性率分别为75%、77.5%、82.5%,对照组黄韧带组织中的表达阳性率分别为40%、20%、40%,退变组明显高于对照组(P<0.05)。结论:IL-1、IL-6、TNF-ɑ在腰椎退变黄韧带中有较高的表达,这些炎性因子可能参与了腰椎黄韧带退变的过程。Objective：To investigate the expression and effect of inflammatory cytokine in ligamentum flavum and the mechanism in degeneration.Method：40 ligamentum flavum specimens were harvested from 40 patients（degenerative group）.All cases presented with ligamentum flavum hypertrophy on CT and MRI imaging and all underwent decompressive laminectomy.Specimens from 10 cases with spine trauma and underwent surgery were regarded as normal controls（normal group）.The ligamentum flavum were free of bone,fat and soft tissue and all were trimed into 2×1.5×0.3cm small pieces.The samples were immediately fixed in 10% buffered formalin for 24-48 hours and embedded in paraffin.Hematoxylin eosin（HE） staining were used to observe pathological changes,and tumor necrotizing factor-α（TNFα）,interleukin-1（IL-1）,and interleukin-6（IL-6） were tested by immunohistochemistry.Result：The elastic fibers in the ligamentum flavum of the normal group presented wave-shape and good arrangement,while it was not the case in the degenerative group.The elastic fibers decreased obviously,collagen fibers increased,and chondrocyte,desmocyte and capillary proliferation were noted.The amount of collagen fibers and fibrocyte showed significant difference between normal and degenerative group（22.56±6.05 cells/HP vs 62.66±18.40 cells/HP）（P0.05）.The expression rate of TNF-α,IL-1 and IL-6 were significantly higher in the degenerative group than in the normal group.IL-1,IL-6 and TNF-ɑ were not expressed or lowly expressed in the normal group,but highly expressive in the cytoplasm or nucleus of degenerative ligamentum flavum,which showed significant difference（P0.05）.Conlusion：The degenerative ligamentum flavum have higher expression of IL-1,IL-6 and TNF-ɑ,which may be associated with the degeneration of ligamentum flavum.

关 键 词：黄韧带 炎性细胞因子 表达 

分 类 号：R681.5[医药卫生—骨科学] R363[医药卫生—外科学]