突出椎间盘新生血管与相关炎性因子研究
发布时间：2019-03-27 13:24
【摘要】：目的:探讨血管浸润的比率,探讨新生血管与年龄、病程、突出分型及术后疗效的相关性,探讨新生血管是否与炎性指标存在相关性,探讨微创手术下是否需要以血管浸润的多少来预判手术效果。方法:用经皮侧路镜手术和经皮椎板间手术方式摘取50例突出的椎间盘突出组织,对其突出类型分型,并分为血管浸润组与非血管浸润组,进行临床观察;并取6例突出椎间盘组织实验研究,观察血管相关因子与炎性因子是否存在关系。结果:整理50例椎间盘组织资料中,有28例为血管浸润,22例无血管浸润,血管浸润率达56%;从表中可以看出血管浸润与否与患者年龄关系不大,无统计学差异;在三种不同椎间盘突出类型中,突出型表达率最低,脱出型较前升高,游离型椎间盘突出中血管浸润率最高,达46.4%,具备明显统计学意义;患者病程在6月以内时,血管浸润率明显高于6月以上的组织血管浸润率,差异具有统计学意义。患者在经皮内径椎间盘摘除术后,症状均得到了明显缓解,术后与术前相比具有明显统计学意义;血管浸润组与非血管浸润组术后疗效相比,不具备统计学差异,不管血管浸润与否不影响患者术后恢复效果。实验结果均能测出炎性相关因子与血管相关因子,但数据量偏少,尚不能说明两者有无相关性。结论:微创脊柱内镜下行单纯腰椎间盘侧路(PETD)或后路髓核摘除术(PEID),两种微创术式均能解决患者的临床症状,具有充分有效性。临床研究表明,患者的年龄与新生血管无关,椎间盘突出越严重,血管浸润率越高,6月内表达率最高,同时血管浸润与否与术后恢复不相关,因此不能根据血管浸润的毛细血管网的多少来判断术中是否一定要在摘除到有血管的组织来预判手术效果。根据实验结果,推测VEGF、CD34血管相关因子数值之间可能存在相关性,IL-lβ、IL-8、TNF-a相关炎性指标的数值可能存在正相关性,并推测血管相关因子的表达量与相关炎性因子的表达量可能存在正相关,但尚需要更大样本及更进一步的研究。
[Abstract]:Objective: to explore the relationship between neovascularization and age, course of disease, prominent classification and postoperative curative effect, and to explore whether neovascularization has correlation with inflammatory index. To explore whether vascular infiltration should be used to predict the outcome of minimally invasive surgery. Methods: 50 cases of herniated intervertebral disc herniated tissue were extracted by percutaneous lateral endoscopy and percutaneous interlaminar surgery. The types of herniation were classified and divided into two groups: vascular infiltrating group and non-vascular infiltrating group. The clinical observation was carried out. The relationship between vascular related factors and inflammatory factors was observed in 6 cases of herniated intervertebral disc tissue. Results: among the 50 cases of intervertebral disc tissue, 28 cases were vascular infiltration, 22 cases had no vascular infiltration, and the rate of vascular infiltration was 56%, and there was no significant difference between vascular infiltration and the age of the patients, and there was no significant difference between vascular infiltration and the age of the patients, and there was no significant difference between vascular infiltration and age. Among the three different types of disc herniation, the expression rate of protrusion type was the lowest, that of prolapse type was higher than that of anterior type, and the rate of vascular infiltration in free disc herniation was the highest (46.4%), which had obvious statistical significance. When the course of disease was within 6 months, the rate of vascular infiltration was significantly higher than that of tissue over 6 months, the difference was statistically significant. After percutaneous discectomy, the symptoms of the patients were relieved obviously, and there was significant statistical significance after the operation compared with that before the operation. There was no statistical difference between the vascular infiltrating group and the non-vascular infiltrating group, no matter whether the vascular infiltration or not had no effect on the postoperative recovery of the patients. The experimental results showed that inflammatory factors and vascular related factors could be detected, but the amount of data was small, which could not explain whether there was correlation between the two factors. Conclusion: both minimally invasive lumbar intervertebral disc lateral approach (PETD) or posterior nucleus pulposus excision (PEID), can solve the clinical symptoms of the patients with minimal invasive spinal endoscopy and are effective and effective in the treatment of lumbar intervertebral disc. [WT5 "HZ] conclusion: [WT5" BZ] Clinical studies showed that the age of the patients had nothing to do with neovascularization. The more severe the disc herniation was, the higher the rate of vascular infiltration was, and the highest expression rate was within 6 months. At the same time, there was no correlation between vascular infiltration and postoperative recovery. Therefore, it is impossible to judge whether the vascular tissue must be removed to predict the effect of the operation according to the size of the vascular infiltrating capillary network. According to the experimental results, we speculate that there may be a correlation between the values of VEGF,CD34 vascular related factors, and the values of IL-l 尾 and IL-8,TNF-a related inflammatory indexes may have a positive correlation. It is speculated that there may be a positive correlation between the expression of vascular-related factors and the expression of related inflammatory factors, but a larger sample and further study are needed.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
，
本文编号：2448221
[Abstract]:Objective: to explore the relationship between neovascularization and age, course of disease, prominent classification and postoperative curative effect, and to explore whether neovascularization has correlation with inflammatory index. To explore whether vascular infiltration should be used to predict the outcome of minimally invasive surgery. Methods: 50 cases of herniated intervertebral disc herniated tissue were extracted by percutaneous lateral endoscopy and percutaneous interlaminar surgery. The types of herniation were classified and divided into two groups: vascular infiltrating group and non-vascular infiltrating group. The clinical observation was carried out. The relationship between vascular related factors and inflammatory factors was observed in 6 cases of herniated intervertebral disc tissue. Results: among the 50 cases of intervertebral disc tissue, 28 cases were vascular infiltration, 22 cases had no vascular infiltration, and the rate of vascular infiltration was 56%, and there was no significant difference between vascular infiltration and the age of the patients, and there was no significant difference between vascular infiltration and the age of the patients, and there was no significant difference between vascular infiltration and age. Among the three different types of disc herniation, the expression rate of protrusion type was the lowest, that of prolapse type was higher than that of anterior type, and the rate of vascular infiltration in free disc herniation was the highest (46.4%), which had obvious statistical significance. When the course of disease was within 6 months, the rate of vascular infiltration was significantly higher than that of tissue over 6 months, the difference was statistically significant. After percutaneous discectomy, the symptoms of the patients were relieved obviously, and there was significant statistical significance after the operation compared with that before the operation. There was no statistical difference between the vascular infiltrating group and the non-vascular infiltrating group, no matter whether the vascular infiltration or not had no effect on the postoperative recovery of the patients. The experimental results showed that inflammatory factors and vascular related factors could be detected, but the amount of data was small, which could not explain whether there was correlation between the two factors. Conclusion: both minimally invasive lumbar intervertebral disc lateral approach (PETD) or posterior nucleus pulposus excision (PEID), can solve the clinical symptoms of the patients with minimal invasive spinal endoscopy and are effective and effective in the treatment of lumbar intervertebral disc. [WT5 "HZ] conclusion: [WT5" BZ] Clinical studies showed that the age of the patients had nothing to do with neovascularization. The more severe the disc herniation was, the higher the rate of vascular infiltration was, and the highest expression rate was within 6 months. At the same time, there was no correlation between vascular infiltration and postoperative recovery. Therefore, it is impossible to judge whether the vascular tissue must be removed to predict the effect of the operation according to the size of the vascular infiltrating capillary network. According to the experimental results, we speculate that there may be a correlation between the values of VEGF,CD34 vascular related factors, and the values of IL-l 尾 and IL-8,TNF-a related inflammatory indexes may have a positive correlation. It is speculated that there may be a positive correlation between the expression of vascular-related factors and the expression of related inflammatory factors, but a larger sample and further study are needed.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.3
，
本文编号：2448221
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