炎性细胞在腹主动脉瘤形成中的作用

Disc degeneration and cervical instability

目的研究炎性细胞在腹主动脉瘤（ａｂｄｏｍｉｎａｌａｏｒｔｉｃａｎｅｕｒｙｓｍ，ＡＡＡ）组织中的浸润情况及其作用。方法２０例ＡＡＡ患者的动脉瘤组织及４例正常人腹主动脉组织，分别行弹力纤维和胶原纤维的特殊染色、单抗白细胞共同抗原（ＣＤ４５阳性）和巨噬细胞（ＣＤ６８阳性）的免疫组化染色，了解纤维组织的变化及炎性细胞的浸润程度；原位杂交方法观察ＡＡＡ组织中基质金属蛋白酶（ｍａｔｒｉｘｍｅｔａｌｏｐｒｏｔｅｉｎａｓｅｓ，ＭＭＰｓ）之ＭＭＰ９的ｍＲＮＡ表达。结果ＡＡＡ组织均有不同程度的炎性细胞浸润，炎性细胞浸润程度与基质弹力纤维的损伤程度呈平行趋势，正常腹主动脉组织无炎性细胞浸润；原位杂交结果显示２０例ＡＡＡ组织中的巨噬细胞和淋巴细胞均出现ＭＭＰ９ｍＲＮＡ的阳性表达，１３例（６５％）ＡＡＡ组织中的平滑肌细胞出现ＭＭＰ９ｍＲＮＡ的阳性表达。正常腹主动脉组织无ＭＭＰ９ｍＲＮＡ的阳性表达。结论炎性细胞在ＡＡＡ形成中通过复杂的生化、细胞及免疫等过程参与并促进了ＡＡＡ的形成。

Objective To evaluate disc degeneration and segmental instability in the cervical spine by comparing the magnetic resonance imaging assessment of disc degeneration with conventional plain radiographic evaluation with cervical segmental instability. Methods Two hundred sixty consecutive patients with suspected cervical spine disorders were analyzed for horizontal and angular displacements on lateral flexion and extension radiographs and disc degeneration on T 2 weighted magnetic resonance images of the cervical vertebrae. Results In all intervertebral levels,the grade of disc degeneration increased significantly ( P <0.01) with age.Cervical instability was identified in 151 segments (14.5%) and correlated with Grade 1 and Grade 2 degeneration in the intervertebral discs ( P <0.01). Conclusions Cervical segmental instability may indicate early degeneration of intervertebral disc in the cervical vertebrae.