【摘要】 目的探讨机体免疫机制引发颈腰疼痛与免疫球蛋白IgG,IgM含量及腰椎间盘突出症病理分型的相互关系。方法采用速率散色比浊法和免疫组化法对58例腰椎间盘突出症患者血清和髓核组织中IgG、IgM进行测定,并记录患者的腰椎间盘突出症病理分型。结果腰椎间盘突出症的合并组(破裂型和游离型)患者外周血中IgG为(14.3±1.9)g/L较对照组(11.4±1.5)g/L显著增高(P<0.05,t=6.75),IgM含量为(1.6±0.5)g/L,也较对照组(1.3±0.5)g/L显著增高(P<0.05,t=5.89);突起组外周血中IgG(12.1±1.6)g/L,IgM(1.3±0.4)g/L与对照组IgG(11.5±1.6)g/L,IgM(1.3±0.5)g/L比较无显著性差异(P>0.05,t=0.53,0.49)。突出的髓核组织中有免疫球蛋白沉积。结论外周血中IgG,IgM的增高有助于区分腰椎间盘突出症的破裂型和游离型,可明确经皮髓核摘除术中的禁忌证;突出的髓核组织中有免疫球蛋白沉积,可引起自身免疫反应性炎症,这是腰椎间盘退行性变、突出和腰腿痛的原因之一。更多还原

【Abstract】 Aim To investigate the relationship of the pathological types of lumbar intervertebral disc herniation and the contents of immunoglobulin IgG, IgM to immunizing mechanism inducing neck and lumbar pain.Methods The pathological types of lumbar disc herniation, the concentrations of IgG and IgM in the serum and nucleus pulposus of 58 patients with lumbar intervertebral disc herniation were examined by ratenephelometry and immunohistochemical methods.Results The concentrations of IgG and IgM in the serum of the united group(extrusion and sequestration groups) were [(14.3±1.9)g/L and (1.6±0.5)g/L respectively, significantly higher than those of the control group(1.4±1.5)g/L and(1.3±0.5)g/L, P< 0.05,t =6.75 and P< 0.05,t=5.89]. The concentrations of IgG and IgM in the serum of the herniation group were (12.1±1.6) g/L and (1.3±0.4) g/L respectively, with no significant difference from those of the control group [(1.5±1.6) g/L and (1.3±0.5) g/L respectively, P >0.05,t=0.53,0.49].Immunoglobulin deposits were found in the nucleus pulposus tissues.Conclusion The concentrations of IgG and IgM in serum conduces to distinguish extrusion from sequestration and to understand the contraindication of percutaneous discectomy; Immunoglobulin deposit found in the nucleus pulposus tissue induces a autoimmune inflammation, which caused degeneration of lumbar intervertebral disc, protrusion, lumbago and leg pain.更多还原