椎间盘退变修复相关治疗方法的研究现状  

The treatment strategies for the repair of intervertebral disc degeneration

作　　者：王尧 蔡晓宇 盛伟斌[1] Wang Yao;Cai Xiaoyu;Sheng Weibin(Department of Spine Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院脊柱外科,乌鲁木齐830054

出　　处：《中华外科杂志》2024年第9期887-892,共6页Chinese Journal of Surgery

基　　金：新疆维吾尔自治区自然科学基金重点项目(2022D01D58);新疆维吾尔自治区自然科学基金青年科学基金(2022D01C745);新疆维吾尔自治区“天山英才”领军人才项目(2023.55);中德合作国际交流项目(M-0726)。

摘　　要：椎间盘退变(IVDD)的传统治疗方法以对症治疗为主,并不能恢复椎间盘的生理结构与功能。因此,越来越多学者开始关注再生医学及其衍生治疗方法在IVDD中的应用。从组织学角度,早期IVDD表现为细胞外基质(ECM)合成与分解代谢失衡,细胞数量变化不大、组织结构较为完整,使用外源性分子或基因治疗进行干预,可实现ECM再生;随着IVDD的进展,细胞数量逐渐减少,此时补充健康细胞并促进ECM合成是治疗的关键;疾病进展到后期,表现为细胞数量明显减少,组织结构紊乱,可使用具有一定机械强度、可负载细胞的生物材料补充ECM与健康细胞,进而实现IVDD的修复。分子、细胞、基因治疗,联合新型生物材料的应用,通过相互弥补短板、协同放大治疗效果的方式治疗IVDD,是未来IVDD修复的发展方向。The traditional treatment of intervertebral disc degeneration(IVDD)mainly focuses on symptomatic treatment,and cannot restore the physiological structure and function of the intervertebral disc.Therefore,more and more scholars begin to pay attention to the application of regenerative medicine and its derived therapeutic methods in IVDD.From the histological perspective,the early stage of IVDD shows the imbalance between synthesis and catabolism,but the cell number and tissue structure are relatively complete,and the intervention of exogenous molecules or gene therapy can achieve extracellular matrix(ECM)regeneration.With the progress of IVDD,the replenishment of healthy cells is the key to treatment.In the final stage,the cell number and tissue structure are disordered.Biological materials with certain mechanical strength and cell load can be used to supplement ECM and healthy cells to realize the repair and regeneration of IVDD.Molecular,cell and gene therapy,combined with the application of new biomaterials,the treatment of IVDD is more inclined to compensate for the shortcomings through a combination approach in the future,in order to achieve the purpose of repair and regeneration.

关 键 词：椎间盘 再生 椎间盘退变 分子治疗 基因治疗 脊柱退行性疾病 生物材料治疗 

分 类 号：R681.53[医药卫生—骨科学]