中央型腰椎管狭窄症患者黄韧带组织生化成分变化的研究

Diversification of biochemical compositions on the lumbar ligamentum flavum due to central lumbar spinal stenosis

目的:通过测定中央型腰椎管狭窄症患者腰椎黄韧带胶原蛋白和蛋白多糖含量变化,观察组织显微结构改变,探讨黄韧带组织生化成分改变与中央型腰椎管狭窄症发病的相关性方法:收集中央型腰椎管狭窄症患者的腰椎黄韧带65块作为退变组,正常腰椎黄韧带27块作为对照组,采用微量羟脯氨酸测定法和硫酸-咔唑法分别测定两组黄韧带中羟脯氨酸及糖醛酸吸光度,并计算胶原蛋白和蛋白多糖含量;游标卡尺测量黄韧带厚度;并行HE染色和Masson染色,显微镜下观察各组组织结构改变。结果:退变组黄韧带厚度、胶原蛋白及蛋白多糖含量均高于对照组,差异有显著性(P<0.05);病理学观察退变黄韧带弹性纤维排列紊乱,数量减少,胶原纤维增生。结论:退变腰椎黄韧带中胶原蛋白和蛋白多糖含量增加,黄韧带生化成分改变可能引起黄韧带厚度增加,参与中央型腰椎管狭窄症的发生。

Objective：To investigate the contents of collagen protein and proteoglycan in ligamentum flavum of lumbar spine as well as the relationship between content diversification in ligamentum flavum and the rate of central lumbar spinal stenosis.Method：65 pieces of ligamentum flavum specimen harvested from patients with central lumbar spinal stenosis were used as degenerative group.Meanwhile 27 specimens from healthy lumbar spine were used as control group.The contents of collagen and proteoglycan in ligamentum flavum were determined by absorbance of hydroxyproline assay,and the uronic acid was determined by micro-hydrox- yproline assay and sulfuric acid-carbazole.The thickness of ligamentum flavum was measured by sliding caliper.Pathological changes were observed following HE and Masson staining.Result：The thickness of ligamentum flavum and the contents of collagen protein and proteoglycan in ligamentum flavum of degenerative group were higher than those of control group,which showed significant difference （P0.05）.Pathology results showed the elastic fibers in ligamentum flavum disorganizing and scant while collagen fibers proliferating in degenerative group.Conclusion：The raising of collagen and proteoglycan as well as changing of its contents in liga- mentum flavum may lead to the increase of ligamentum flavum′s thickness,which contribute to central lumbar spinal stenosis.