超声引导下针刀松解黄韧带对兔退变腰椎间盘整合素α5、β1表达的影响  

Effect of ultrasound-guided needle-knife release of the ligamentum flavum on the expression of integrin alpha5 and beta1 in degenerative rabbit lumbar intervertebral discs

作　　者：陈灿 赵宇 胡斌涵 杜梦凡 刘俊宁 牛素生 张燕[1,2] Chen Can;Zhao Yu;Hu Binhan;Du Mengfan;Liu Junning;Niu Susheng;Zhang Yan(School of Traditional Chinese Medicine,Fuiian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian Province,China;Key Laboratory of Orthopedics&Traumatology of Traditional Chinese Medicine and Rehabilitation,Ministry of Education,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,Fujian Province,China)

机构地区：[1]福建中医药大学中医学院,福建省福州市350122 [2]福建中医药大学中医骨伤及运动康复教育部重点实验室,福建省福州市350122

出　　处：《中国组织工程研究》2025年第2期331-338,共8页Chinese Journal of Tissue Engineering Research

基　　金：福建省自然科学基金项目(2023J01862),项目负责人:张燕;福建中医药大学基础类学科科研提升计划项目(XJC2022008),项目负责人:张燕。

摘　　要：背景:针刀松解黄韧带可有效改善腰椎退行性患者的症状,超声引导可增加针刀松解的精准性,但针刀松解黄韧带后对退变椎间盘的具体影响及可能的机制尚待明确。目的:探讨超声引导下针刀松解黄韧带对兔腰椎间盘退变的作用。方法:取24只新西兰兔,采用随机数字表法分为对照组(n=6)与造模组(n=18)。造模组采用横断L5/6、L6/7节段棘上、棘间韧带并保持站立姿势对腰椎施加轴向载荷的方式建立兔腰椎间盘退变模型,造模成功后再随机分为模型组、超声针刀组、假针刀组,每组6只,超声针刀组在超声引导下使用针刀松解L7/S1右侧黄韧带,假针刀组针刀入路同超声针刀组,但不松解黄韧带,1次/周,共4次。针刀干预后30 d,利用MRI观察L7/S1椎间盘髓核信号强度变化,苏木精-伊红染色观察L7/S1椎间盘形态变化,免疫组化染色检测L7/S1椎间盘髓核内Ⅰ,Ⅱ型胶原表达,RT-PCR、Western Blot检测L7/S1椎间盘中整合素α5、β1、p38、核因子κB的表达。结果与结论:①MRI成像显示,模型组兔椎间盘髓核呈灰-黑色,髓核灰度值明显低于对照组(P<0.01);超声针刀组兔椎间盘髓核亮度较模型组升高,髓核灰度值高于模型组(P<0.01);②苏木精-伊红染色显示,模型组髓核形状不规则,髓核细胞数量减少,细胞外基质被压缩,纤维环破裂,终板结构与边界不清,软骨细胞排列紊乱;与模型组相比,超声针刀组髓核细胞数量增多,纤维环破裂情况有改善,软骨终板细胞排列较为规则;③免疫组化染色显示,与对照组比较,模型组髓核内Ⅰ型胶原阳性表达增加(P<0.01),Ⅱ型胶原阳性表达减少(P<0.01);与模型组比较,超声针刀组髓核内Ⅰ型胶原阳性表达减少(P<0.01),Ⅱ型胶原阳性表达增加(P<0.01);④RT-PCR、Western Blot检测显示,与对照组比较,模型组兔椎间盘中整合素α5、整合素β1、p38、核因子κB的mRNA与蛋白表达均升高(P<0.01);与模型组�BACKGROUND:Needle-knife release of the ligamentum flavum can effectively improve symptoms in patients with lumbar degeneration,and ultrasound guidance can increase the precision of needle-knife release;however,the specific effects of needle-knife release of the ligamentum flavum on the degenerated intervertebral discs and the possible mechanisms remain to be clarified.OBJECTIVE:To investigate the effect of ultrasound-guided needle-knife release of the ligamentum flavum.METHODS:Twenty-four New Zealand rabbits were randomized into control(n=6)and model(n=18)groups.A rabbit model of lumbar disc degeneration model was established in the model group by cutting the supraspinous and interspinous ligaments of the L5/6 and L6/7 segments to maintain a standing posture and apply axial load to the lumbar spine.After successful modeling,the model rabbits were subdivided into a control group,a model group,an ultrasonic needleknife group,and a sham needle-knife group according to a random number table method,with six animals in each group.The ultrasonic needle-knife group underwent ultrasound-guided needle-knife release of the right yellow ligament of L7/S1,once every week,for a total of four times.The needle-knife approach in the sham needle-knife group was the same as that in the ultrasound needle-knife group,but the ligamentum flavum was not released.At 30 days after the intervention,MRI was used to observe the changes in the signal intensity of the nucleus pulposus within the L7/S1 segment.Hematoxylin-eosin staining was used to observe the morphological changes of the L7/S1 segment.Immunohistochemical staining was used to detect the expression of type I and II collagen in the nucleus pulposus of the L7/S1 segment.RT-PCR and western blot were used to detect the expression of integrinα5 andβ1,p38,and nuclear factorκB in the L7/S1 segment.RESULTS AND CONCLUSION:MRI findings indicated that the nucleus pulposus of the intervertebral disc of rabbits in the model group was gray-black in color,and the gray value of the nucleus p

关 键 词：腰椎间盘退变 针刀 黄韧带 超声引导 整合素 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R245.3