磷脂酶A_2在腰椎间盘突出症髓核中的表达及相关临床研究

Expression and associative clinical study of phospholipase A_2 in the nuclei pulposus of herniated lumbar discs

目的 探讨磷脂酶 A2 (PL A2 )在腰椎间盘突出症中的作用机制。方法 1.在术前和术中收集 35例因腰椎间盘突出而手术的病人的疼痛程度、直腿抬高试验度数、突出病理征象等临床资料 ,采集突出组和对照组 (8例 )的血清和髓核标本。2 .应用微孔比色法测定 PL A2 的活性。 3.将获得的数据和临床资料进行统计学分析。结果 突出组髓核中的 PL A2 活性高于对照组 ,血清中两组无差异。髓核 PL A2 活性在破裂型或游离型中同在凸起型中的表达有差异 (P <0 .0 5 ) ,与直腿抬高试验度数呈负相关 (r=- 0 .344 ) ,与疼痛存在相关性 (P <0 .0 5 )。结论 腰椎间盘突出症髓核的 PL A2 活性高于正常腰椎间盘 ,化学性炎症机制在腰椎间盘突出症根性疼痛中发挥着可能比机械压迫更重要、更直接的作用 ,PL A2

Objective To explore the functional mechanism of phospholipase A 2(PLA 2) in the nuclei pulposus(NP) of herniated lumbar discs Methods To collect the clinical materials-grades of pain, degrees of straight leg raising(DSLR), protrudent pathology and so on, of 35 operated patients of herniated lumbar discs (herniated groups), and the samples of serums and pulposus of the herniated and control groups in the preoperation and operation To assay PLA 2 and to perform statistical analysis Results The activities of PLA2 in NP of the herniated groups are over the control groups ,but these in serum aren't different The activities of PLA 2 are variant in the projecting types and negative correlation with DSLR, as well as, correlation with the grades of pain Conclusion The activities of PLA 2 in herniated discs are very much more than these in normal discs Chemical inflammatory mechanisms may play more important and direct role than mechanical compression in sciatica of herniated lumbar discs and inhibitors of PLA 2 will come to a new medicament for treating herniated lumbar discs