非压迫性椎间盘髓核突出致神经根损伤中自身免疫反应的研究

Autoimmune research on nerve root injury induced by non-compressive nucleus pulposus protrusion

目的:探讨非压迫性椎间盘髓核突出中自身免疫反应对神经根损伤的作用机制及临床意义。方法:雌性SD大鼠48只,随机分成模型组、对照组,每组24只。造模后10 d、20 d、40 d,每组随机抽取8只,测定左后肢痛阈;检测动脉血中CD4+、CD8+T细胞比例及血清中TNF-α表达;HE染色观察神经根形态学变化。结果:模型组在10 d、20 d时,左后肢痛阈、CD4+、CD8+T细胞比例及TNF-α表达与对照组比较,差异均有统计学意义,在40 d时两组比较,差异均无统计学差异。模型组10 d时腰神经根横断面髓鞘部分崩解,呈空泡变;20 d时最严重,40 d时基本恢复正常;对照组未见异常。结论:在非压迫性椎间盘髓核突出早期,T细胞介导的自身免疫及TNF-α对神经根损伤发挥重要作用。

Objective：To discuss the autoimmune response on the mechanism and clinical significance of nerve root injury induced by the non-compressive nucleus pulposus protrusion. Methods： Forty-eight female SD rats were randomly divided. Twenty-four female SD rats were recruited as model group,and the others as control. After ten days,twenty days and forty days,the pain threshold of left hind leg and the levels of TNF-α,CD4＋,CD8＋T cells were measured,the nerve root changes in morphology were observed by HE. Results： Compared with the control group,model group in ten days,twenty days,which left hind leg pain threshold,the proportion of CD4,CD8＋T cell and the expression of TNF-α are significantly different. After forty days,these two groups have no statistical difference. After ten days,lumbar nerve root cross-sectional myelin of model group was partial disintegrated. The worst damage happened in twenty days,and almost recovered to normal in forty days. Conclusion： T cell-mediated autoimmunity and TNF-α play an important role to the nerve root injury in the early time of the non-compressive nucleus pulposus protrusion.