慢性炎症因素在颈椎病发病中的作用-外科学(骨外)专业论文.docxVIP

慢性炎症因素在颈椎病发病中的作用导师：蔡钦林教授，王少波主任医师 慢性炎症因素在颈椎病发病中的作用 导师：蔡钦林教授，王少波主任医师 研究生：王圣林 论文摘要 目的：探讨颈椎病患者突出间盘组织内是否存在炎症反应，炎症反应在颈 椎病发病机制中的作用，炎症反应的原因及其影像学表现。方法：研究79 例颈椎病患者，手术共切除102个间盘；进行HE染色及免疫组化染色。 将染色结果结合其临床表现、影像学资料进行研究。结果：(1)102个间 盘中45个(44．1％)突出间盘组织内可见血管增生、炎症细胞浸润，炎症 反应多发生在突出间盘进入椎管部分的边缘；45个出现炎症反应的间盘， 37个间盘浸润的炎症细胞LCA染色阳性，32个间盘内炎症细胞KP．1染 色阳性： 5个无炎症反应的间盘存在KP．1染色阳性的软骨细胞。(2)炎 症组与无炎症组患者在平均病程、术后脊髓功能改善方面存在显著性差 异。(3)炎症反应与病史的特殊表现、颈椎不稳定之间存在显著相关性， 并与MRj影像的特异表现显著相关。结论：(1)颈椎病患者突出间盘周围 组织存在炎症反应，炎症浸润细胞多为单核．巨噬细胞及淋巴细胞；(2)颈 椎不稳定可能是间盘周围组织产生炎症反应的原因之一；(3)颈椎间盘周 围的炎症反应在MⅪ影像上有其特异表现；(4)慢性炎症因素可能参与了 颈椎病的发病。 关键词：颈椎病；发病机制；炎症 The The role of chronic inflammation in pathogenesis of cervical spondylosis． Supervisor：Prof．Cai Qinlin，Prof．Wang Shaobo Graduate student：Wang Shenglin Abstract Objective：To study whether the inflammation exists in herniated cervical intervertebral discs from patients with cervical spondylosis，the role of inflammation in pathogenesis of cervical spondylosis，the cause of inflammation， and its imageological signs．Method：79 patients were studied，and 1 02 discs were obtained during operation．The 1 02 discs were used for histologic and immunohistochemical examination，and their clinical presents and images were studied．Results：(1)45 discs(44．1％)were shown proliferating small vessels and inflammatory cells．The inflammation were all in the margin of hemiated tissues of the discs．In the 45 inflammatory discs，37 had many LCA—positive cells，and 32 discs were infiltrated by KP-1 positive cells．In the 57 discs which had no inflammation，5 had KP-1 positive cartilage cells．(2)The course of patients with inflammation had significant difference with patients that had no inflammation； SO do the spinal cord function improvement．(3)Inflammation was significantly correlated with special history of cervical spondylosis，cervical instability and special signs on MRI．Conclusion：(1)Patients with cervical spondylosis have inflammation in the tissues of herniated discs，and most of the inflammatory cells were monocy