微血管形成在腰椎间盘退变过程中的表现特征及影响因素

Characteristics and Influencing Factors of Micro Vessel Formation in the Process of Lumbar Intervertebral Disc Degeneration

目的观察微血管形成在腰椎间盘退变过程中的病理表现特征,并分析其相关影响因素.方法选取48例行单节段腰椎后路经椎间孔减压椎间植骨融合内固定术患者,术中切取患处组织,冷冻切片后HE染色,观察病理改变,Weidner微血管计数法统计微血管密度.根据是否有微血管分为有微血管组、无微血管组,比较微血管形成的可能影响因素,对差异具有统计学意义的因素进一步行Logistics回归分析.结果 25例患者椎间盘内存在明显微血管形成,组织切片中存在典型的条形管腔结构,血管内皮细胞核有明显蓝染,微血管形成率为52.08%,MVD值平均为11.9±2.5.有微血管组椎间盘钙化率明显高于无微血管组,差异具有显著统计学意义(P<0.01);有微血管组JOA评分明显低于无微血管组,腰椎疼痛VAS评分明显高于无微血管组,差异具有统计学意义(P<0.05);椎间盘退变程度、椎间盘疝出程度两组间比较差异无统计学意义(P>0.05).多因素回归分析显示:椎间盘钙化、腰椎疼痛VAS评分与退变椎间盘内微血管形成有明显相关性(OR值分别8.992,7.359,P值均<0.05).结论椎间盘退变伴随着微血管形成,椎间盘钙化、腰椎疼痛VAS评分与退变腰椎间盘微血管形成有关.

Objective To observe the pathological characteristics of the formation of micro vessels in the process of lumbar disc degeneration and analyze the related influencing factors. Method 48 patients with single segment lumbar interbody fusion and internal fixation were performed. During the operation, the affected tissue was removed and prepared into frozen sections, and dyed with hematoxylin and eosin （HE） staining for the observation of pathological changes;Weidner micro vascular count was used for the observation of microvessel density. According to whether there was microvessel or not, the samples were divided into microvascular group and nonmicrovaseular group, for the observation of the possible factors that might affect the formation of micro vessels and the further line Logistics regression analysis of the factors with statistically significant difference. Results An obvious formation of microvessels was found in 25 patients, in which the typical strip lumen structure could be seen in the tissue sections, the vascular endothelial cell nucleus was obviously blue-stained, and the microvessel formation rate was 52.08%, with an average MVD value of 11.9 ±2.5. The intervertebral disc calcification rate in the microvascular group was significantly higher than that in the non-microvascular group （P〈0.01） ;The JOA score in the microvascular group was significantly lower than that non-microvascular group and the lumbar pain VAS score in the microvascular group was significantly higher than that the nonmicrovascular group （ P〈0.05 ） ; there was no significant difference in intervertebral disc degeneration and disc herniation between the two groups （ P〉0.05 ）. The multivariate regression analysis revealed that the intervertebral disc calcification and lumbar pain VAS score were significantly correlated with the microvessel formation in the degenerated intervertebral disc （ OR values were 8. 992 and 7. 359, respectively, P〈0.05 ）. Conclusion The disc degeneration accompanies the microvessel formation, and the disc calcification and lumbar pain VAS score are associated with the development of microvessels in the degenerative lumbar disc.