等离子髓核成形术对兔退变腰椎间盘内磷脂酶A2活性的影响

The effect of coblation on the phospholipase A2 activity in the degenerative intervertebral disc in rabbit model

目的:观察等离子髓核成形术对兔退变椎间盘组织内磷脂酶A2(phospholipase A2,PLA2)活性的影响,探讨其治疗椎间盘源性腰痛的可能机制。方法:选取纯种新西兰大白兔46只,随机分为模型组38只,正常组8只,模型组用16号注射针穿刺建立L4/5、L5/6椎间盘退变动物模型。将造模成功的36只兔分为模型治疗组及模型对照组,每组18只,模型治疗组行等离子髓核成形术,对照组不做处理,分别在术后即刻、1周、1个月时处死动物,取L4/5、L5/6椎间盘进行PLA2活性检测,正常组在实验结束时取L4/5、L5/6椎间盘进行PLA2活性检测。结果:正常组椎间盘组织中PLA2的活性为80.68±5.56;模型治疗组消融术后即刻椎间盘组织内PLA2活性为184.98±9.43,术后1周为154.39±7.99,术后1个月为142.64±10.72;模型对照组相应时间点椎间盘组织内PLA2活性分别为194.86±11.80,195.2±13.90,225.98±12.59。模型组各时间点的PLA2活性均较正常组明显升高(P<0.01);模型治疗组各时间点与相应时间点模型对照组比较差异有显著性(P<0.05);模型治疗组术后1周的PLA2水平较术后即刻明显降低(P<0.01),术后1个月较术后1周仍有降低。结论:等离子髓核成形术可以降低退变椎间盘内磷脂酶A2活性,可能是治疗椎间盘源性腰痛的机制之一。

Objective：To explore the effect of coblation on the phospholipase A2（PLA2） activity in degenerative intervertebral disc and investigate the possible mechanism of coblation in treatment of dicogenic back pain.Method：A total of 46 New Zealand White rabbits were divided into 2 groups at random：animal model group （n=38） and non-animal model group（n=8）.The L4/5,L5/6 were exposed respectively in animal model group,then,the two levels were stabbed by 16-gauge hypodermic needle to establish the degenerative intervertebral disc.36 animal models were successfully establised which were further subdivided into 2 groups： coblation group（n=18）,non-coblation group（n=18）.Coblation was performed on the coblation group.The activity of PLA2 in the intervertebral disc of L4/5,L5/6 was determined at 3 different time intervals after coblation：at once, 1 week, 1 month.The same procedure was also processed at the end of the experimental study in the non-coblation group.Result：The activity of PLA2 in non-animal model group and animal model non-coblation group was 80.68±5.56 and 194.86±11.80, there was significant difference between two groups （P〈0.01）.In the animal model group,activity of PLA2 in both coblation and non-coblation groups was 184.98±9.43 and 194.86±11.80 at once after coblation,154.39±7.99 and 195.20±13.90 a week after coblation,142.63±10.72 and 225.98±12.59 a month after coblation.The activity of PLA2 in 1 week was significantly lower than that at the real time （P〈0.01） in coblation group.There was a statistical significance of the activity of PLA2 between coblation group and non-coblation group （P〈0.05） at corresponding different time intervals.The activity of PLA2 in 1 month was still lower than that in 1 week.Conclusion：The coblation could degrade the activity of PLA2 in the degenerative intervertebral disc.It maybe one of the possible mechanisms of coblation in treatment of dicogenic back pain.