【摘要】 目的研究胸椎骨化黄韧带的组织病理学、骨形态发生蛋白(BMP)的表达与 CT 值及其对应关系,为临床间接通过 CT 值确定黄韧带骨化的病理类型、制订治疗方案提供参考依据。方法病例组23例均为胸椎黄韧带骨化患者(排除由 DISH 病、强直性脊柱炎、氟骨症等继发的胸椎黄韧带骨化),并按黄韧带骨化病理分型分为成熟型和非成熟型,平均年龄51岁,病程2个月～9年。对照组5例均无黄韧带骨化,为胸椎外伤行手术治疗的青年患者,平均27岁。采用 CT 测定黄韧带各个部位;SP 免疫组化法测定 BMP。结果根据病理分型,病例组有49节非成熟型和21节成熟型黄韧带骨化。病例组 CT 值(547.2±131.4)显著高于对照组(137.7±10.6)(t=6.922,P=0.000),而且成熟型骨化(702.9±17.7)显著高于非成熟型骨化(480.5±180.2)(t=5.623,P=0.000)。对照组和成熟型骨化中 BMP 均呈阴性表达,而在非成熟骨化中呈现高表达,成熟型骨化与非成熟型骨化表达有显著差异(x~2=70.000,P=0.000)。结论 CT 值与病理结果及 BMP 评价黄韧带骨化成熟度基本一致,可通过 CT 值术前评估胸椎黄韧带骨化的成熟度,从而为制订治疗方案提供理论依据。更多还原

【Abstract】 Objective To investigate the correlation of pathology,bone morphogentic protein (BMP)expression,CT value with the ossification of thoracic ligamentum flavum(TOLF)to afford the evidence to choose appropriate treatment methods.Methods Twenty-three patients aged 35-65 years old had TOLF in my hospital as case.Their courses of disease were 2 months to 9 years.The values of blood calcium,blood phosphorus and AKP in them were normal.The 5 peoples aged 21-35 years old who presented fracture of thoracic but not the ligamentum flavum ossification were selected as control.We excluded those who have DISH,ankylosing spondylitis,fluorosis and other disease related with TOLF.The lesion locus were scanned and mensurated by CT.The pathology characteristics were classified into immature ossification and mature ossification by general observation,histology examination.BMP were measured by the immunohistochemical(IHC)staining techniques.Results The CT value was significantly higher in the case group(547.2±131.4)than controlled group(137.7±10.6)(t=6.922,P=0.000).Further,the CT value in the mature ossification(702.9±17.7)was significantly higher than the immature(480.5± 180.2)(t=5.623,P=0.000).In addition,BMP both expressed negative in the mature ossification and the controlled group,but positive in the immature ossification.BMP expression was significantly different between the immature ossification and the mature(x~2=70.000,P=0.000).Conclusions The CT values, pathological types and BMP expression results are similar to evaluate the ossification degrees of ligamentum flavum,and then could be indireethy judged the maturation degrees of TOLF by CT to confirm the treatment methods before operation.更多还原