环氧合酶-2、前列腺素E2在突出腰椎间盘中的表达及其意义  

Expression and clinical significance of cyclooxygenase-2 and prostaglandin E_2 in lumbar disc herniation

作　　者：姜志钊[1] 李毅中[1] 

机构地区：[1]福建医科大学附属第二医院重症医学科,福建泉州362000

出　　处：《临床骨科杂志》2014年第6期730-733,共4页Journal of Clinical Orthopaedics

摘　　要：目的：探讨环氧合酶-2（COX-2）、前列腺素E2（PGE2）在突出腰椎间盘组织中的表达及其在坐骨神经痛发病机制中的作用。方法病变组42个突出椎间盘标本取自42例因腰椎间盘突出并具有坐骨神经放射性疼痛症状行手术治疗的患者,包括突起型12例,破裂型15例,游离型15例,取材部位为紧贴神经根突入椎管的椎间盘组织（A部位）和椎间隙内残存的椎间盘组织（B部位）。对照组5个标本取自1例新鲜年轻尸体的L1-S1椎间盘组织,取材部位为椎间盘边缘（ A部位）和中央髓核（ B部位）。术前对所有患者的坐骨神经痛严重程度进行视觉模拟疼痛评分（ VAS）。应用ELISA方法检测各组标本中COX-2和PGE2的含量。结果COX-2和PGE2在腰椎间盘突出组中的含量明显高于对照组（ P〈0．01）；突出组A部位COX-2和PGE2的含量从突起型到→破裂型→游离型均逐渐升高,差异有统计学意义（ P〈0．01）。突出组A部位COX-2和PGE2的含量要高于B部位（ P〈0．01）；突出腰椎间盘组织中 COX-2和 PGE2的含量之间存在明显相关性（ r =0．863,P〈0．01）；PGE2的含量与患者坐骨神经痛的VAS评分存在明显相关性（r=0．848,P〈0．01）。结论COX-2与PGE2的含量密切相关,并参与对PGE2表达的调控；PGE2的含量与坐骨神经痛的严重程度密切相关。Objective To investigate the expression of cyclooxygenase-2 （ COX-2 ） and prostaglandin E2 （ PGE2 ） in lumbar disc herniation and explore their significance in the pathogenesis of sciatica. Methods 42 discs from patients with lumbar disc herniation （12 inflation type, 15 extrusion type, 15 sequestration type） and had the sciatic nerve ra-dioactive pain symptoms went to surgery were collected. The disc herniation was obtained from two zones of disc：Zone A was hernia tissue or separate fragment, Zone B was the remainder nucleus pulpous of lumbar intervetebral disc. In control group, 5 normal discs were harvested from 1 young fresh specimen obtained from two zone of disc. Zone A was the margin of lumbar intervetebral disc, Zone B was the center nucleus pulpous of lumbar intervetebral disc. Before the operation of all such patients in sciatica severity score for visual analogue scale （ VAS） . The content of COX-2 and PGE2 were evaluated with enzyme linked immunosorbent assay （ ELISA ） . Results The content of COX-2 and PGE2 in lumbar intervetebral disc tissue was obviously higher than that of the normal control grorp. The content of COX-2 and PGE2 gradually raised from inflation,extrasion to sequestration type at Zone A in LDH group（ P〈0. 01）. The content of COX-2 and PGE2 were higher at Zone A than at Zone B in LDH group（P〈0. 01）. A posi-tive correlation was found between the content of COX-2 and PGE2 in LDH group（r=0. 863,P〈0. 01）. At the same time,the content of PGE2 and VAS also had a positive correlation in LDH group（r=0. 848,P〈0. 01）. Conclusions COX-2 and PGE2 are involved in the pathogenesis of lumbar disc degeneration and lumbar disc herniation. COX-2 and PGE2 play critical role in the development of lumbar disc herniation and herniation. COX-2 participate in the reg-ulation of the expression of PGE2 . The content of PGE2 have a closely relationship with the degree of sciatica.

关 键 词：腰椎间盘突出症 环氧合酶-2 前列腺素E2 坐骨神经痛 

分 类 号：R681.5[医药卫生—骨科学] R971.3[医药卫生—外科学]