il1β il6及tnfα在脊柱结核椎间盘病灶中的表达及意义-expression and significance of il 1β il 6 and tnf α in spinal tuberculosis intervertebral disc lesions.docx

IL-1β、IL-6及TNF-α在脊柱结核椎间盘病灶中的表达及意义摘要目的：明确脊柱结核椎间盘病灶中白介素-1β（IL-1β）、白介素-6（IL-6）及肿瘤坏死因子-a（TNF-α）因子表达及意义。方法：收集2013年3月-2015年3月我院（309医院）脊柱外科脊柱结核患者临床资料25例,其中男性15例，女性10例，年龄20～64岁，平均38.3±10.57岁。正常组入组15例，男性8例，女性7例，年龄20～64岁，平均38.12±13.03岁。根据术前影像学资料及术中观察情况以及术后病理明确诊断。脊柱爆裂型骨折，行减压、椎间融合15例患者，摘除椎间盘组织作为对照组。术中分别切取两组椎间盘组织进行HE及抗酸染色，IL-1β、IL-6及TNF-α免疫组化染色。光镜下观察两组标本中IL-1β、IL-6及TNF-α的阳性表达并进行阳性颗粒计数。结果：HE染色发现：结核病灶内胶质较多呈淡黄色，均质细腻，形似奶酪。镜下为红染无颗粒状结构。抗酸染色镜下观察，纤维组织以干酪样坏死为主,可见大量炎性肉芽肿，阳性杆菌被查及，结核分枝杆菌表现为成堆束状，细而长直棒状亮红色微弯杆菌，杆菌清晰；而其他成分主要以亮红色或淡蓝色为主，有折光性。细菌在淡蓝色背景下颜色与背景着色对比显著。免疫组织化学染色显示，两组病例中椎间盘组织，均能检测出IL-1β、IL-6及TNF-α三种因子的表达，经t检验，脊柱结核病变组IL-1β、IL-6及TNF-α的表达显著高于正常对照组，统计学有显著差异（P0.01）。结论：1.脊柱结核病灶椎间盘中促炎因子IL-1β、IL-6及TNF-α大量增加；2.结核病灶中IL-1β、IL-6及TNF-α的高表达可能是具有良好的保护性炎性反应因子；3.参与结核免疫的细胞因子IL-1β、IL-6及TNF-α也可能是增加椎间盘浸润原因。关键词：脊柱结核；白细胞介素-1β；白细胞介素6；肿瘤坏死因子-α；免疫组化TheExpressionandSignificanceofIL-1β、IL-6andTNF-αintheLesionsofSpinalTuberculosisAbstractObjective:Toconfirmthetuberculosisofspineintervertebraldisclesionsoftheinterleukin-1β（IL-1β),theinterleukin--6（IL-6）andtumornecrosisfactor-a（TNF-α）factorexpressionandsignificance.Methods:WEhadcollectedtheclinicaldataof25cases(male15,female10)inthehospital(309hospital)fromMarch,2013toMatch,2015.Thesepatientsateaged20-64withavetageage38.3±10.57.15cases(male8,female7)weteincludedinthestudu.Thesepatientsareaged20-64withaverageage38.12±13.03.Afterconfirmaeddiagnoses,accordingtotheimagingdatabeforeoperation,observedinforinformationinoperationandpathologicalexaminationafteroperation,therewere15casesofvertebralburstracture,decompressionandinstrumentedfusion,Intervertebraldisctissueswereexcised,whichwasactedasacontrolgroup.Discmaterialoftwogroupswerecutrespectively,thenastainforacidfastbacilliandHEstain,aswellasIL-1β、IL-6andTNF-αimmunohistochemicalstainaredone.PositiveexpressionofL-1β、IL-6andTNF-αintwogroupswereobservedunderlightmicroscopeandpositiveguanuleswerecounted.Results:WithHEsatain,gliomaisyellowshapedlikecheesewithfinetextureinspinaltuberculosisinfection.Microscopically,itischaracter