黄韧带中成纤维细胞生长因子1、血管内皮生长因子表达与腰椎管狭窄患者腰椎减压术后再狭窄的关系

7Analysis of the relationship between FGF⁃1 and VEGF expression in the ligamentum flavum of patients with lumbar spinal stenosis and restenosis after decompression

目的 探讨腰椎管狭窄(LSS)患者黄韧带中成纤维细胞生长因子1(FGF-1)、血管内皮生长因子(VEGF)表达与腰椎减压术后再狭窄的关系。方法 选择138例行腰椎减压术治疗的LSS患者,分为轻度组[绝对跛行距离(ACD)≤200 m,41例]、中度组(ACD 201~400 m,67例)和重度组(ACD> 400 m,30例),另选择138例非LSS患者为对照组。检测黄韧带组织FGF-1、VEGF表达,术后随访统计再狭窄发生情况。结果 LSS组黄韧带组织中FGF-1表达低于对照组(P <0.001),VEGF表达高于对照组(P <0.001)。重度组黄韧带组织中FGF-1表达低于中度组和低度组(P <0.05),VEGF表达高于中度组和低度组(P <0.05)。LSS椎管重度狭窄、减压不彻底、VEGF高表达是LSS患者腰椎减压术后再狭窄危险因素(P <0.05,P <0.001),FGF-1是保护因素(P <0.05)。结论 LSS患者黄韧带组织中FGF-1表达降低,VEGF表达升高,且与椎管狭窄程度以及术后再狭窄有关。

Objective To investigate the relationship between the expressions of fibroblast growth factor 1(FGF-1)and vascular endothelial growth factor(VEGF)in the ligamentum luteum in patients with lumbar spinal stenosis(LSS)and restenosis after decompression.Methods 138 LSS patients underwent lumbar decompression were selected,including mild group[absolute claudication distance(ACD)≤200 m,41 cases],moderate group(ACD 201~400 m,67 cases)and severe group(ACD>400 m,30 cases),and 138 non-LSS patients were selected as control group.The expressions of FGF-1 and VEGF in ligamentum flavum were detected,and the restenosis was measured after the operation.Results The expression of FGF-1 in LSS group was lower than that in control group(P<0.001),and the expression of VEGF was higher than that in control group(P<0.001).The expression of FGF-1 in severe group was lower than that in moderate and low degree groups(P<0.05),and the expression of VEGF was higher than that in moderate and low degree groups(P<0.05).Severe spinal stenosis,incomplete decom-pression and high expression of VEGF were risk factors for restenosis after lumbar decompression in patients with LSS(P<0.05,P<0.001),and FGF-1 was protective factor(P<0.05).Conclusion FGF-1 expression decreased and VEGF expression increased in ligamentum flavum of LSS patients,which was related to the degree of spinal ca-nal stenosis and postoperative restenosis.