兔侧后方入路髓核内注射TGF-β1预防软骨终板退变实验研究

An Experimental Study of Intra-nucleus Gelatinosus Injection of Transforming Growth Factor-β1 through Posterior-lateral Approach in Prevention of Degeneration of Cartilage Endplate

目的探讨经侧后方入路髓核内注射转化生长因子-β1（transforming growth factor-β1,TGF-β1）预防椎间失稳后软骨终板退变的作用。方法选择6月龄日本大耳白兔36只,随机分为对照组和观察组各18只。两组均通过椎间失稳手术制备成腰5~6、腰6~7椎间失稳模型。观察组在术后立即经侧后方入路髓核内注射TGF-β1 25~30μl。于术后3个月、6个月各取8只动物,分别切取腰5~6、腰6~7椎间盘的软骨终板,对标本进行HE染色组织形态学观察及Mankin评分,测定Ⅱ型胶原,进行组间比较。结果术后3个月、6个月组织形态学显示观察组较对照组软骨终板退变明显减缓,Mankin评分显著低于对照组（P〈0.01）;观察组软骨终板内Ⅱ型胶原表达灰度值显著低于对照组（P〈0.01）。结论髓核内注射TGF-β1对椎间失稳手术后软骨终板退变具有明显的预防作用。

Objective To investigate the effect of intra-nucleus gelatinosus injection of transforming growth factor-β1（TGF-β1） through posterior-lateral approach in prevention of degeneration of cartilage endplate due to intervertebral destabilization.Methods 36 six-month-old oryctolagus cuniculus were chosen and divided into control group and observation group（18 in each）.Both groups were rendered to models with L5～6 and L6～7 destabilization by intervertebral destabilization surgery.The observation group received intra-nucleus gelatinosus injection of TGF-β1 through posterior-lateral approach after the surgery in the 3rd and 6th month,cartilage endplates of L5～6 and L6～7 were excised in 8 oryctolagus cuniculus respectively.Hematoxylin and eosin stain was used to observe the histomorphology of the samples,and Mankin score was used to evaluate the cartilage endplates.Type Ⅱcollagen was determined,and all the results in both groups were compared.Results In the 3rd and 6th month after surgery,the degeneration of cartilage endplates in observation group was slower than that in the control group,Mankin score was significantly lower than that in the control group（P0.01）,and grey scale value of expression of type Ⅱcollagen in cartilage endplates was significantly lower than that in the control group（P0.01）.Conclusion： Intra-nucleus gelatinosus injection of TGF-β1 can prevent the degeneration of the cartilage endplate due to intervertebral destabilization.