选择性神经根造影联合阻滞术治疗对椎间盘突出症患者脑脊液P物质和胱抑蛋白C的影响

Effect of selective nerve root radiography combined with blocking on Substance P and neuropeptides in cerebrospinal fluid in patients with disc herniation

目的探讨选择性神经根造影联合阻滞术治疗对椎间盘突出症患者疼痛缓解的机制,比较治疗前后脑脊液中反映疼痛指标的P物质和胱抑蛋白C的表达水平。方法回顾性分析2011年3月至2016年3月收入深圳市龙华区人民医院和西京医院脊柱外科的82例因疼痛为主要临床表现[视觉模拟评分(VAS)为7~10分,重度]而需进行选择性神经根造影联合阻滞术治疗的椎间盘突出症患者资料。使用酶联免疫吸附试验(ELISA)和蛋白质免疫印迹(Western blot)两种检测方法分析患者治疗前、治疗后3 d、1周、2周、4周脑脊液中P物质和胱抑蛋白C的含量。结果在颈椎和腰椎病变的椎间盘突出症患者,经选择性神经根造影联合阻滞术治疗后3 d、1周、2周、4周,脑脊液中P物质蛋白和胱抑蛋白C的含量均显著降低,与治疗前相比差异均具有统计学意义(P<0.05)。结论选择性神经根造影联合阻滞术治疗对椎间盘突出症患者疼痛的缓解作用与脑脊液中P物质和胱抑蛋白C的含量降低密切相关。

Objective To explore the exact mechanisms that selective never root radiography combined with blocking treatment caused pain relief in the patients of intervertebral disc herniation and to compare the expression levels of Substance P and Cystatin C in the cerebrospinal fluid between pre-treatment and post-treatment.Methods 82 intervertebral disc herniation patients with significant pain were treated by selective neve root radiography combined with blocking.Then,ELISA and Western blot were performed to evaluate the expression levels of Substance P and Cystatin C.Results After 3 days,1 week,2 weeks and 4 weeks,the Substance P and Cystatin C expression levels in the cerebrospinal fluid were significantly decreased after selective nerve root radiography combined with blocking,compared with before treatment with statistically significant difference.Conclusion The pain relief mechanisms of selective nerve root angiography plus block treatment may be due to the decrease of Substance P and Cystatin C expression levels.