【摘要】：目的探討白細(xì)胞介素(IL)-17在疝出型和退變突出型腰椎間盤組織中表達(dá)的差異及Modic改變與突出類型的相關(guān)性和病理機(jī)制。方法確診并行手術(shù)治療的單節(jié)段腰椎間盤突出患者62例,根據(jù)椎間盤突出類型分為損傷疝出組41例和退變突出組21例。根據(jù)磁共振成像(MRI)將病例分為Modic改變組22例和非Modic改變組40例。術(shù)中取椎間盤標(biāo)本,采用蘇木素-伊紅(HE)染色、免疫組化染色、SYBR green法熒光定量PCR觀察并檢測(cè)椎間盤組織病理改變和IL-17表達(dá)情況。結(jié)果損傷疝出組新生血管化發(fā)生率明顯高于退變突出組(P0.01)。退變突出組IL-17陽(yáng)性細(xì)胞數(shù)明顯低于損傷疝出組(P0.01)。損傷疝出組椎間盤組織中IL-17 mRNA表達(dá)量明顯高于退變突出組(P0.01)。Modic改變組椎間盤組織中IL-17 mRNA表達(dá)量明顯高于非Modic改變組(P0.01)。疝出型IL-17 mRNA表達(dá)量與Modic改變之間存在明顯相關(guān)性(R=0.61,P0.001)。結(jié)論損傷疝出型腰椎間盤髓核組織中存在明顯的局部炎性反應(yīng);IL-17在損傷疝出型椎間盤表達(dá)明顯,提示介導(dǎo)了椎間盤神經(jīng)根微環(huán)境的免疫炎癥變化;自身免疫反應(yīng)參與了Modic改變的病理機(jī)制。
[Abstract]:Objective to investigate the expression of interleukin-17 (IL) 17) in herniated and degenerative lumbar intervertebral disc tissues, and to explore the relationship between Modic changes and herniation type. Methods Sixty-two patients with single segment lumbar disc herniation were divided into injury herniation group (41 cases) and degenerative herniation group (21 cases) according to the type of disc herniation. According to magnetic resonance imaging (MRI), the patients were divided into Modic change group (n = 22) and non-Modic group (n = 40). Intraoperative specimens of intervertebral discs were stained with hematoxylin-eosin (HE) and immunohistochemical, SYBR green quantitative PCR was used to detect the pathological changes and IL-17 expression of intervertebral discs. Results the incidence of neovascularization in the hernia injury group was significantly higher than that in the degenerative herniation group (P 0.01). The number of IL-17 positive cells in degenerative herniation group was significantly lower than that in injured hernia group (P0.01). The expression of IL-17 mRNA in the injured hernia group was significantly higher than that in the degenerative herniation group (P0.01). Modic was significantly higher than that in the non-Modic change group (P0.01). There was a significant correlation between the expression of IL-17 mRNA in hernia type and the change of Modic (P 0.001). Conclusion there is a significant local inflammatory response in the nucleus pulposus of the injured herniated lumbar intervertebral disc and the expression of IL-17 in the injured herniated disc suggests that it mediates the changes of immune inflammation in the microenvironment of the nerve root of the intervertebral disc. Autoimmune response is involved in the pathological mechanism of Modic changes.
【作者單位】： 焦作市人民醫(yī)院骨科;
【基金】：河南省重點(diǎn)科技攻關(guān)基金資助項(xiàng)目(No.1321023104)
【分類號(hào)】：R681.53

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