突出椎間盤新生血管與相關(guān)炎性因子研究
發(fā)布時間：2019-03-27 13:24
【摘要】：目的:探討血管浸潤的比率,探討新生血管與年齡、病程、突出分型及術(shù)后療效的相關(guān)性,探討新生血管是否與炎性指標(biāo)存在相關(guān)性,探討微創(chuàng)手術(shù)下是否需要以血管浸潤的多少來預(yù)判手術(shù)效果。方法:用經(jīng)皮側(cè)路鏡手術(shù)和經(jīng)皮椎板間手術(shù)方式摘取50例突出的椎間盤突出組織,對其突出類型分型,并分為血管浸潤組與非血管浸潤組,進行臨床觀察;并取6例突出椎間盤組織實驗研究,觀察血管相關(guān)因子與炎性因子是否存在關(guān)系。結(jié)果:整理50例椎間盤組織資料中,有28例為血管浸潤,22例無血管浸潤,血管浸潤率達56%;從表中可以看出血管浸潤與否與患者年齡關(guān)系不大,無統(tǒng)計學(xué)差異;在三種不同椎間盤突出類型中,突出型表達率最低,脫出型較前升高,游離型椎間盤突出中血管浸潤率最高,達46.4%,具備明顯統(tǒng)計學(xué)意義;患者病程在6月以內(nèi)時,血管浸潤率明顯高于6月以上的組織血管浸潤率,差異具有統(tǒng)計學(xué)意義�；颊咴诮�(jīng)皮內(nèi)徑椎間盤摘除術(shù)后,癥狀均得到了明顯緩解,術(shù)后與術(shù)前相比具有明顯統(tǒng)計學(xué)意義;血管浸潤組與非血管浸潤組術(shù)后療效相比,不具備統(tǒng)計學(xué)差異,不管血管浸潤與否不影響患者術(shù)后恢復(fù)效果。實驗結(jié)果均能測出炎性相關(guān)因子與血管相關(guān)因子,但數(shù)據(jù)量偏少,尚不能說明兩者有無相關(guān)性。結(jié)論:微創(chuàng)脊柱內(nèi)鏡下行單純腰椎間盤側(cè)路(PETD)或后路髓核摘除術(shù)(PEID),兩種微創(chuàng)術(shù)式均能解決患者的臨床癥狀,具有充分有效性。臨床研究表明,患者的年齡與新生血管無關(guān),椎間盤突出越嚴(yán)重,血管浸潤率越高,6月內(nèi)表達率最高,同時血管浸潤與否與術(shù)后恢復(fù)不相關(guān),因此不能根據(jù)血管浸潤的毛細(xì)血管網(wǎng)的多少來判斷術(shù)中是否一定要在摘除到有血管的組織來預(yù)判手術(shù)效果。根據(jù)實驗結(jié)果,推測VEGF、CD34血管相關(guān)因子數(shù)值之間可能存在相關(guān)性,IL-lβ、IL-8、TNF-a相關(guān)炎性指標(biāo)的數(shù)值可能存在正相關(guān)性,并推測血管相關(guān)因子的表達量與相關(guān)炎性因子的表達量可能存在正相關(guān),但尚需要更大樣本及更進一步的研究。
[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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3
，
本文編號：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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.3
，
本文編號：2448221
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