脊髓型颈椎病患者颈椎间盘白细胞介素6和肿瘤坏死因子α水平与日本骨科学会颈髓功能评分的相关性

Contents of interleukin-6 and tumor necrosis factor-alpha in the cervical intervertebral disks of patients with cervical spondylotic myelopathy associated with the Japanese Orthopaedic Association Score for cervical spinal cord function

目的:检测脊髓型颈椎病患者颈椎间盘组织中白细胞介素6、肿瘤坏死因子α的水平,分析其与日本骨科协会颈髓功能评分(JOA)的相关性,探讨免疫反应在脊髓型颈椎病发病机制中的作用。方法:病例来源于2005-11-10/2006-06-30在安徽医科大学第一附属医院骨科住院患者,27例脊髓型颈椎病患者为脊髓型颈椎病组,另外16例无颈椎病史的颈椎外伤患者为对照组。两组均经颈椎前路手术中切取的颈椎间盘组织,应用放射免疫分析法测定两组椎间盘组织中白细胞介素6和肿瘤坏死因子α的水平。脊髓型颈椎病患者组依据JOA评分分成重、中度组(0～12分,20例)和轻度组(13～17分,7例)。结果:43例全部进入结果分析。①脊髓型颈椎病组颈椎间盘组织内白细胞介素6、肿瘤坏死因子α的水平均明显高于对照组[白细胞介素6:(34.521±18.592),(15.041±6.562)ng/L;肿瘤坏死因子α:(6.071±1.912),(3.143±0.630)pmol/L;P均<0.01]。②脊髓型颈椎病患者重、中度组椎间盘中肿瘤坏死因子α水平明显高于轻度组(P<0.01)。结论:①脊髓型颈椎病患者的颈椎间盘组织内白细胞介素6、肿瘤坏死因子α的分泌增多。②脊髓型颈椎病患者颈椎间盘中肿瘤坏死因子α的水平与脊髓功能有相关性,提示脊髓型颈椎病患者临床症状的轻重与免疫反应之间存在着一定的关系。

AIM： To measure the contents of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in the cervical intervertebral disk of patients with cervical spondylotic myelopathy （CSM）, analyze the relationship of IL-6 and TNF-α contents with the Japanese Orthopaedic Association （JOA） score, study the role of immune reaction in the pathogenesis of CSM. METHODS： Twenty-seven inpatients with CSM were enrolled as case group, sixteen patients were enrolled in the surgical operation patients with traumatic cervical injury served as control group, who had no CSM disease history in the Department of Orthopaedics, First Affiliated Hospital, Anhui Medical University from November 10^th, 2005 to June 30^th, 2006. Cervical intervertebral disks were obtained from patients of the two groups undergoing anterior surgery. The contents of IL-6 and TNF-α in all specimens of the two groups were measured with radioimmunoassay （RIA） method. The 27 CSM sufferers were divided into two groups according to the JOA score： moderate and severe group scored from 0-12 points, totally 20 patients, and mild group scored from 13-17 points, totally 7 patients. RESULTS： Totally 43 cases were involved, in the result analysis. （1）The contents of IL-6 and TNF-α in disk of CSM sufferers increased significantly compared with the control group [IL-6：（34.521±18.592）, （15.041±6.562） ng/L;TNF-α： （6.071 ±1.912）, （3.143±0.630） pmol/L; P 〈 0.01]. （2）The content of TNF-α increased significantly in moderate and severe group of JOA score 0-12 compared with mild group of JOA score 13-17 （P 〈 0.01）. CONCLUSION： （1）The IL-6 and TNF-α secretes to increase in the cervical intervertebral disks of CSM patients. （2）The content of TNF-α in the cervical intervertebral disks of CSM patients is associated with spinal cord function. It indicates that the severity of the clinical symptoms of the patients with CSM has certain association with immune reaction.