阚敏慧，才素分，武英蕾

唐山市第二医院麻醉科，河北省唐山市  063000

Expression of cytokine in the lumbar spinal stenosis and hypertrophic ligamentum flavum   

Kan Min-hui, Cai Su-fen, Wu Ying-lei

Department of Anesthesiology, Tangshan Second Hospital, Tangshan  063000, Hebei Province, China

Abstract
BACKGROUND: A majority of clinical studies are focus on morphology and histology of hypertrophic ligamentum flavum. However, there is not unified understanding of the etiological significance of hypertrophic ligamentum flavum on lumbar spinal stenosis, rather than cytokine levels.    
OBJECTIVE: To study the etiology of the degenerative and hypertrophic ligamentum flavum and its relationship to lumbar spinal stenosis on the level of cytokines.
METHODS: Ligamentum flavum specimens were obtained at operation from 25 cases of lumbar spinal stenosis and 25 cases of lumbar disc herniation. These slices were selected for immunohistochemistry staining. The expression of transforming growth factor β1, tumor necrosis factor α and interleukin 6 were observed and compared between two groups.
RESULTS AND CONCLUSION: Compared with the lumbar disc herniation group, the positive expression of transforming growth factor β1, tumor necrosis factor α and interleukin 6 were higher in ligamentum flavum of the lumbar spinal stenosis group
(P < 0.01). The findings demonstrated that the expression of transforming growth factor β1, tumor necrosis factor α and interleukin 6 in ligamentum flavum presetned with relative consistency. Sterile inflammatory cytokines also lead to the degeneration, proliferation and hypertrophy of lumbar ligamentum flavum.

摘要
背景：临床上大多数研究都是针对肥厚黄韧带的形态学与组织学方面的研究，而对于黄韧带肥厚在腰椎管狭窄症中的病因学意义，目前尚缺乏统一的认识，尤其在细胞因子水平上的研究甚少。
目的：通过在细胞因子水平的研究探讨腰椎黄韧带变性、肥厚的病因及其与腰椎管狭窄症的关系。
方法：选择华北煤炭医学院附属骨科医院(唐山市第二医院)2008/2009腰椎管狭窄症和椎间盘突出症住院患者各25例，比较2组患者黄韧带中白细胞介素6、转化生长因子β1、肿瘤坏死因子α阳性表达程度及黄韧带中3种炎性因子阳性表达率。
结果与结论：两组患者黄韧带中白细胞介素6、转化生长因子β1、肿瘤坏死因子α阳性表达程度比较，腰椎管狭窄症组明显高于腰椎间盘突出症组(P < 0.01)。提示白细胞介素6、转化生长因子β1、肿瘤坏死因子α在椎管狭窄症肥厚黄韧带中的表达呈相对一致性，有80%左右均明显增高。黄韧带变性、增殖、肥厚，也是无菌性炎性因子作用的结果。
关键词：腰椎管狭窄症；腰椎间盘突出症；黄韧带变性肥厚；细胞因子；免疫组织化学
doi:10.3969/j.issn.1673-8225.2010.46.036

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