脊髓型颈椎病椎间盘白细胞介素1水平与颈脊髓功能的相关性

Correlation between interleukin-1 in cervical intervertebral discs and function of the cervical spine cord in cervical spondylotic myelopathy

背景:白细胞介素1自身及其产生的级联反应在椎间盘退变及周围组织如脊髓的功能障碍中起着重要作用。目的:分析脊髓型颈椎病患者颈椎间盘白细胞介素1α、白细胞介素1β水平及其与颈脊髓功能的相关性,探讨白细胞介素1在脊髓型颈椎病发病机制中可能起到的作用。设计、时间及地点:实验采用对比观察,于2008-01/11在安徽医科大学第一附属医院骨科及安徽医科大学寄生虫学实验室完成。对象:实验组收集安徽医科大学第一附属医院2008-01/10骨科住院的25例脊髓型颈椎病患者48个椎间盘组织,因颈椎创伤的10例患者20个椎间盘组织作为对照。标本均为颈椎前路手术摘取且患者自愿捐献。方法:应用酶联免疫吸附(ELISA)法测量两组颈椎间盘白细胞介素1α、白细胞介素1β的水平;采用日本骨科协会颈脊髓功能评分(JOA评分17分法)对实验组病例进行术前颈脊髓功能评分。主要观察指标:①两组椎间盘组织中的白细胞介素1α、白细胞介素1β水平。②实验组椎间盘组织中的白细胞介素1α、白细胞介素1β质量浓度与JOA评分相关性分析。结果:所收集的病例全部纳入结果分析。脊髓型颈椎病患者椎间盘组织白细胞介素1α、白细胞介素1β质量浓度水平明显高于对照组(P<0.01)。脊髓型颈椎病患者椎间盘组织中的白细胞介素1α、白细胞介素1β质量浓度与JOA评分间呈负相关(ra=-0.860;rb=-0.669,P<0.01)。结论:脊髓型颈椎病患者颈椎间盘组织的白细胞介素1α、白细胞介素1β水平明显增高,且与颈脊髓功能成负相关。

BACKGROUND： Interleukin-1 （IL-1） and its cascade reaction play an important role in intervertebral disc degeneration or neurological deficit. OBJECTIVE： To analyze the correlation between level of IL-1 a and IL-1 13 in cervical intervertebral discs and function of cervical spine cord, and to explore the effect of interleukin-1 on pathogenesis of cervical spondylotic myelopathy. DESIGN, TIME AND SETTING： The comparative observation experiment was performed at the Department of Orthopaedics, First Affiliated Hospital Anhui Medical University and the Laboratory of Department of Parasitology, Anhui Medical University from January to November 2008. PARTICIPANTS： A total of 48 intervertebral discs tissues from 25 patients with cervical spondylotic myelopathy enrolled in First Affiliated Hospital Anhui Medical University from January to October 2008 were collected. Twenty intervertebral discs of 10 inpatients with traumatic cervical injury were served as the control group. All samples were obtained from patients who underwent anterior neck surgery and donated voluntarily. METHODS： The contents of IL-1 a and IL-1.8 in specimens were analyzed by ELISA method, the cervical spine cord function were measured by the Japanese Orthopedic Association （JOA） scoring system score before operation. MAIN OUTCOME MEASURES： The contents of IL-1α and IL-1β in intervertebral discs, and the correlation between mass concentration of IL-1α/IL-1β of the cervical intervertebral discs and JOA scores in the experimental group were observed. RESULTS： All the cases were involved in the final analysis. The contents of IL-1α and IL-1β in experimental group were obvious increased compared with the control group （P 〈 0.01）. There had a negative correlation between IL-1 α, IL-1β and the JOA score in the experimental group （ra=-0.860, rb =-0.669, P 〈 0.01）. CONCLUSION： The contents of IL-1α and IL-1β in the cervical intervertebral discs of cervical spondylotic myelopathy are significant increased, which have a negative correlation with the JOA score.