腰椎间盘源性神经痛免疫复合物表达及富血小板血浆的治疗机制

Immune complex expression and platelet-rich plasma repairing mechanism for lumbar discogenic neuralgia

背景:免疫机制在腰椎间盘源性神经痛的发生发展中起着重要作用,富血小板血浆是治疗腰椎间盘源性神经痛等腰椎退行性疾病的有效手段之一,探讨腰椎间盘源性神经痛的免疫复合物表达及富血小板血浆的治疗机制,可为预防和及时治疗椎间盘退变继发的神经痛提供新思路。目的:综述腰椎间盘源性神经痛的免疫机制及富血小板血浆治疗机制的研究进展,并进行展望。方法:检索Pub Med数据库、中国知网(CNKI)及维普数据库(VIP),英文检索词为“Disc degeneration、Lumbar discogenic neuralgia、Lumbar discogenicsciatica、sciatica、PRP、Plateletrichplasma、immunologicalresponse”,中文检索词为“椎间盘退变、腰椎间盘源性神经痛、腰椎间盘源性坐骨神经痛、坐骨神经痛、PRP、富血小板血浆、免疫反应”,根据纳入与排除标准对所有文章进行初筛后,最终纳入86篇文章进行综述。结果与结论:免疫机制在腰椎间盘退变中的作用已被广泛研究,对于腰椎间盘源性神经痛的产生发展起着关键作用,各免疫炎症因子是导致神经根性疼痛的关键递质。富血小板血浆对于腰椎间盘源性神经痛的治疗主要基于其丰富的生长因子,涉及抗炎及神经保护、免疫调节、促进许旺细胞活化及轴突再生、促进椎间盘退变的修复及血管形成等方面作用。

BACKGROUND:Immune mechanism plays an important role in the occurrence and development of lumbar discogenic neuralgia.Platelet-rich plasma is one of the effective means for the treatment of lumbar degenerative diseases such as lumbar discogenic neuralgia.Exploring the expression of immune complex of lumbar discogenic neuralgia and the therapeutic mechanism of platelet-rich plasma can provide new ideas for the prevention and timely treatment of neuralgia secondary to disc degeneration.OBJECTIVE:To review the immune mechanism of lumbar discogenic neuralgia and the therapeutic mechanism of platelet-rich plasma,and make a prospect.METHODS:PubMed database,CNKI database and VIP database were searched.The English and Chinese search terms were“disc degeneration,lumbar discogenic neuralgia,lumbar discogenic sciatica,sciatica,PRP,platelet rich plasma,immunological response”.After preliminary screening of all articles according to inclusion and exclusion criteria,86 articles were finally included for review.RESULTS AND CONCLUSION:The role of immune mechanism in lumbar intervertebral disc degeneration has been extensively studied,and it plays a key role in the generation and development of lumbar discogenic neuralgia.Various immune inflammatory factors are the key mediators leading to nerve root pain.The treatment of lumbar discogenic neuralgia by platelet-rich plasma is mainly based on its rich growth factors,including anti-inflammatory and neuroprotection,immunomodulation,Schwann cell activation and axon regeneration,intervertebral disc degeneration repairing and angiogenesis.