腰椎终板退行性改变与髓核内炎症因子及下腰痛相关性研究  

Correlation between the lumbar end-plate Modic degeneration and inflammatory factors in Iumbar nucleus pulposus or low back pain

作　　者：郑月焕[1] 曹鹏[1] 张兴凯[1] 梁裕[1] 吴文坚[1] 龚耀成[1] 郑涛[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院骨科上海市伤骨科研究所,200025

出　　处：《国际骨科学杂志》2011年第4期253-256,共4页International Journal of Orthopaedics

基　　金：国家自然科学基金(81071502)

摘　　要：目的探讨腰椎椎间盘终板退变(Modic改变,MC)与髓核内炎症因子浓度及下腰痛之间的相关性。方法选取2008年1月至12月我院骨科40例腰椎退变性疾病手术治疗病人42个髓核组织作为研究样本。手术前记录病人病变椎间盘和正常椎间隙高度、MC高度,下腰痛视觉模拟评分(VAS)等相关信息。根据病人术前MRI影像上有无MC分为无MC组(A组)和有MC组(B组)。采用酶联免疫吸附试验(ELISA)检测样本中炎症因子白细胞介素(IL)-1β、IL-6和肿瘤坏死因子(TNF)-α浓度。采用SPSS 11.0软件对数据进行统计分析。结果病人髓核样本IL-1β、IL-6、TNF-α浓度,A组分别为88.94pg/ml、52.88pg/ml、259.33pg/ml,B组分别为136.56pg/ml、75.71pg/ml、338.45pg/ml;A、B组下腰痛VAS评分分别为5.21分、6.63分,病变节段椎间隙高度丢失率分别为0.23%、0.48%。三项指标之差异均具有统计学意义(P<0.05),但炎症因子浓度与下腰痛VAS评分及MC高度之间的相关性无统计学意义(P>0.05)。结论 MC是腰椎退变程度较严重的表现,退变椎间盘内产生的炎症因子是MC可能病因之一。Objective To investigate the correlation of the Modic change（MC）of lumbar end-plate on MRI with the inflammatory factors in lumbar nucleus pulposus or the low back pain.Methods Forty-two lumbar intervertebral disc samples of 40 patients were harvested during surgery for lumbar degeneration in our hospital.Before operation,height of normal and abnormal intervertebral disc space,height of MC signals,visual analogue scale（VAS）measuring pain severity of the patients were recorded.The concentrations of interleukin-1β（IL-1β）.interleukin-6（IL-6）and tumor necrosis factor-α（TNF-α）in the samples were determined by enzyme linked immunosorbent assay（ELISA）.According to MRI,all patients were divided into two groups： group A included samples with no MC,group B included samples with MC.Finally all the results were analysed by using SPSS 11.0 software.Results The concentrations of IL-1β,IL-6 and TNF-αwere 88.94±33.41 pg/ml,52.88±15.09 pg/ml and 259.33±43.47 pg/ml in group A,136.56±32.57 pg/ml,75.71±25.55 pg/ml and 338.45±47.22 pg/ml in group B.VAS scores were 5.21±1.42 in Group A,6.63±1.30 in Group B.The rates of disc space height loss were 0.23%±0.13%in Group A.0.48%±0.22%in Group B.The concentration of inflammatory factors,VAS score and rate of disc space height loss in group B were all significantly higher than that in group A（P0.05）.There was no positive correlation between the concentration of inflammatory factors and the MC height or the severity of low back pain of the two group（P0.05）.Conclusions The occurrence of MC suggests that the degeneration of lumbar discs and the low back pain are more severe.Inflammatory factors in lumbar nucleus pulposus are one of the causes of MC.

关 键 词：腰椎退行性变 MODIC改变 腰背痛 炎症因子 

分 类 号：R681.53[医药卫生—骨科学]