不同类型腰椎退行性变患者椎间盘IL-6、IL-1β和COX-2的表达研究

Study on the Expression of Intervertebral Disc IL-6,IL-1βand COX-2 in Patients with Different Types of Lumbar Degeneration

目的检测白细胞介素6(IL-6)、白细胞介素1β(IL-1β)和环氧化酶2(COX-2)在不同类型的腰脊髓压迫患者椎间盘中的表达,探讨相关因子和腰脊髓压迫类型的相关性及在腰椎退变过程中的意义。方法选取2017年7月~2018年11月于我科行腰椎后路间盘切除内固定术的患者90例,根据不同类型分为腰椎管狭窄症组30例,腰椎间盘突出症组30例,腰椎外伤组30例,对手术切除的椎间盘组织通过HE染色及免疫组织化学染色进行形态学观察,同时计数IL-6、IL-1β和COX-2免疫组织化学染色表达阳性的细胞,IL-6、IL-1β及COX-2和腰脊髓压迫类型的相关性。结果①腰椎管狭窄症组及腰椎间盘突出症组椎间盘组织在HE染色后观察可见炎性细胞浸润及新生血管形成;腰椎外伤组椎间盘组织则无上述表现;②腰椎管狭窄症组椎间盘组织在免疫组织化学染色后可见较多IL-1β、IL-6表达阳性的细胞,COX-2表达阳性的细胞稀少;腰椎间盘突出症组中IL-1β、IL-6、COX-2表达阳性的细胞数量均较多;腰椎外伤组中IL-1β、IL-6、COX-2表达阳性的细胞均稀少;③腰椎管狭窄症组及腰椎间盘突出症组椎间盘组织中IL-1β、IL-6阳性表达率高于腰椎外伤组,腰椎间盘突出症组中COX-2阳性表达率高于腰椎管狭窄症组及腰椎外伤组,差异均有统计学意义(P<0.05)。结论发生退行性变的腰椎间盘组织中存在IL-1β、IL-6、COX-2细胞因子表达,并在腰椎间盘早期退变中发挥作用,不同类型的腰脊髓神经压迫患者IL-1β、IL-6、COX-2的表达存在一定差异。

Objective To detect the expression of interleukin 6(IL-6),interleukin 1β(IL-1β)and cyclooxygenase 2(COX-2)in the intervertebral discs of patients with different types of lumbar spinal cord compression.To explore the correlation between related factors and the type of lumbar spinal cord compression and its significance in the process of lumbar degeneration.Methods A total of 90 patients who underwent lumbar discectomy and internal fixation in our department from July 2017 to November 2018 were selected.According to different types,they were divided into 30 cases of lumbar spinal stenosis group,30 cases of lumbar disc herniation,and 30 cases of lumbar trauma group.Morphological observation of the surgically removed intervertebral disc tissue by HE staining and immunohistochemical staining,At the same time,count the cells with positive expression of IL-6,IL-1βand COX-2 immunohistochemical staining,and the correlation between IL-6,IL-1βand COX-2 and the type of lumbar spinal cord compression.Results①The intervertebral disc tissues of the lumbar spinal stenosis group and the lumbar disc herniation group showed inflammatory cell infiltration and neovascularization after HE staining;the intervertebral disc tissue of the lumbar trauma group had no such manifestations;②In the lumbar spinal stenosis group,there were more IL-1βand IL-6 positive cells in the intervertebral disc tissue after immunohistochemical staining,and COX-2 positive cells were rare;The number of cells with positive expression of IL-1β,IL-6 and COX-2 in the lumbar disc herniation group were all more;In the lumbar spine trauma group,the cells with positive expression of IL-1β,IL-6 and COX-2 were rare;③The positive expression rate of IL-1βand IL-6 in the intervertebral disc tissue of the lumbar spinal stenosis group and the lumbar disc herniation group was higher than that of the lumbar trauma group,and the positive expression rate of COX-2 in the lumbar disc herniation group was higher than that of the lumbar spinal stenosis group and the lumbar trauma group,the difference was statistically significant(P<0.05).Conclusion There are IL-1β,IL-6,COX-2 cytokine expressions in degenerative lumbar intervertebral disc tissue,and they play a role in the early degeneration of lumbar intervertebral disc.There are certain differences in the expression of IL-1β,IL-6 and COX-2 in patients with different types of lumbar spinal cord nerve compression.