椎间盘病变椎间盘髓核及纤维环MMP-1及TIMP-1表达变化及意义  

Expression and significance of MMP-1 and TIMP-1 in the nucleus pulposus and anulus fibrosus of intervertebral disc with different lesions

作　　者：冯习坤[1] 孙马玲 曾昭池[3] 郭立新[3,4] FENG Xi-kun SUN Ma-ling ZENG Zhao-chi GUO Li-xin(Physical Examination Center, 169th Hospital of PLA,Xiang- nan Hospital of Hunan Normal University, Hengyang Hunan 421002, China Medical Department, 169th Hospital of PLA, Xiangnan Hospital of Hunan Normal University, Hengyang Hnnan 421002, China Orthopedics Department, 169th Hospital of PLA, Xiangnan Hospital of Hu- nan Normal University, Hengyang Hunan 421002, China Administrative Office, 169th Hospital of PLA, Xiangnan Hospital of Hunan Normal University, Hengyang Hunan 421002, China)

机构地区：[1]解放军第169医院暨湖南师范大学附属湘南医院体检中心,湖南衡阳421002 [2]解放军第169医院瞥湖南师范大学附属湘南医院医务科,湖南衡阳421002 [3]解放军第169医院暨湖南师范大学附属湘南医院骨科,湖南衡阳421002 [4]解放军第169医院暨湖南师范大学附属湘南医院院长办公室,湖南衡阳421002

出　　处：《局解手术学杂志》2017年第8期573-576,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：湖南省卫计委2015年度科研计划项目(B2015-64)

摘　　要：目的研究椎间盘病变椎间盘髓核及纤维环MMP-1及TIMP-1表达变化及意义。方法选取我院2014年8月至2016年8月收治的34例椎间盘突出症患者作为观察组,将同期34例突发创伤致椎体骨折手术摘除椎间盘患者作为对照组。手术分离椎间盘髓核及纤维环,用免疫组化法检测MMP-1、TIMP-1表达,分析MMP-1、TIMP-1表达与椎间盘退行性病变的关系。结果观察组髓核MMP-1、TIMP-1表达量明显高于对照组(P<0.05);且在突出型、脱出型、游离型椎间盘退变中,髓核MMP-1、TIMP-1表达量依次下降(P<0.05)。观察组纤维环MMP-1、TIMP-1表达量明显高于对照组(P<0.05);且在突出型、脱出型、游离型椎间盘退变中,纤维环MMP-1、TIMP-1表达量依次下降(P<0.05)。髓核及纤维环MMP-1、TIMP-1高表达,发生椎间盘退行性病变的风险明显高于MMP-1、TIMP-1低表达者(P<0.05)。MMP-1作为预测椎间盘退行性病变的灵敏度为82.35%,特异度为94.11%;TIMP-1作为预测椎间盘退行性病变的灵敏度为79.41%,特异度为88.24%;联合二者,其预测椎间盘退行性病变的灵敏度为90.91%,特异度为97.14%。结论椎间盘退行性病变患者椎间盘髓核及纤维环MMP-1、TIMP-1的表达明显增高,对协助诊断椎间盘退行性病变具有重要临床意义。Objective To explore the expression and significance of MMP-1 and TIMP-1 in the nucleus pulposus and anulus fibrosus of intervertebral disc with different lesions. Methods From August 2014 to August 2016,34 cases of lumbar disc herniation （ the observation group） and 34 case of surgical removal of intervertebral disc in patients with vertebral trauma caused by sudden trauma （ the control group） in our hospital were stuided. The nucleus pulposus and anulus fibrosus of intervertebral disc were separated, and the expression of MMP-1 and TIMP-1 were detected by immunohistochemistry. The relationship between MMP-1 and TIMP-1 expression and intervertebral disc degeneration was analyzed. Results The MMP-1 and TIMP-1 expression of nucleus pulposus in the observation group were significantly higher than those in the control group（P 〉 0.05 ） ;and the MMP-1 and TIMP-1 expression of nucleus pulposus decreased successively in prominent type,extru- sion type, free type lumbar intervertebral disc degeneration（P 〈 0.05 ）. The MMP-1 and TIMP-1 expression of anulus fibrosus in the observa- tion group were significantly higher than those in the control group （P 〉 0.05 ） ;and the MMP-1 and TIMP-1 expression of anulus fibrosus de- creased successively in prominent type, extrusion type, free type lumbar intervertebral disc degeneration （ P 〈 0.05 ）. Patients with high expres- sion of MMP-1 and TIMP-1 in nucleus pulposus and anulus fibrosus had more risk of degenerative disc disease（ P 〈0.05 ）. As a sensitivity prediction of intervertebral disc degeneration, the sensitivity of MMP-1 was 82.35 % while the specificity was 94.11%, and the sensitivity of TIMP-1 was 79.41% while the specificity was 88.24%. The prediction sensitivity of intervertebral disc degeneration was 90.91% and the specificity was 97.14% when combined MMP-1 with TIMP-1. Conclusion The expression of MMP-1 and TIMP-1 in the nucleus pulposus and anulus fibrosus of intervertebral disc degeneration was significantly increased, which is

关 键 词：椎间盘髓核 椎间盘纤维环 椎间盘病变 MMP-1 TIMP-1 

分 类 号：R681.5[医药卫生—骨科学]