腰椎间盘组织的炎症诱导效应的实验研究

Inflammatory-inducing effect of lumbar disc tissue:An experimental study

目的 :探讨腰椎间盘组织是否具有产生或诱导白细胞产生炎症介质磷脂酶A2 (PLA2 )的能力并寻找有效实用的抑制药物。方法 :取腰椎间盘突出症患者的椎间盘标本 1 0份 ,抽取这 1 0名患者的周围血标本 ,从血中分离出单个核细胞。将同一患者的椎间盘和单个核细胞按下列 5组进行培养 :组 1为单个核细胞 ,组 2为椎间盘 ,组 3为灭活椎间盘 +单个核细胞 ,组 4为灭活椎间盘 +单个核细胞 +地塞米松 ,组 5为灭活椎间盘 +单个核细胞 +青蒿酯。测定磷脂酶A2 的活性。结果 :组 1 ,2 ,4,5与组 3比较均差异有显著性 (P <0 .0 1 )。组 5与组 4比较差异无显著性 (P>0 .0 5 )。结论 :①椎间盘组织的某些成分可诱导单个核细胞产生高活性PLA2 ;PLA2 很可能是腰椎间盘突出症患者产生腰腿痛的炎症介质并进一步诱导产生其他炎症介质 ;②在体外 ,青蒿素具有抑制PLA2 产生的作用。此作用与地塞米松相近。

Objective To study whether herniated or degenerative lumbar disc tissues have the potentials to produce or induce peripheral blood white cells to produce inflammatory mediator phospholipase A 2 (PLA 2 ), and to find the effective inhibitors of PLA 2. Methods Ten specimens of lumbar discs were obtained when patients were performed operations. The peripheral blood samples were drawn out from the same ten patients (7 ml per patient) . Mononuclear white cells were separated from each peripheral blood sample. Then, cell culture was performed according to the following combinations: Grou p 1 was mononuclearcytes ; Group 2 was disc tissue; Group 3 was devitalized disc tissue+ mononuclearcytes; Group 4 was devitalized disc+mononuclearcytes+dexamethasone; Group 5 was devitalized disc+mononuclearcytes+artemisinin. The activity of PLA 2 was detected at last. Results Compared with Group 3, other groups had a significant difference, (P<0.01). Group 5 compared with Group 4 had no significant difference (P>0.05). Conclusions ①Some components in disc tissue can induce mononuclearcytes to produce high activity of PLA 2 which is an inflammatory mediator very possible to cause back pain and radiculopathy in lumbar disc herniation.② Artemisinin has similar effectiveness to dexamethasone to inhibit the production of PLA 2 in vitro.