CAJ | 학술논문

目的：比较细胞因子基质金属蛋白酶3（matrix metalloproteinases 3，MMP-3）、IgG和CD68在青少年与中老年患者突出腰椎间盘组织中的表达，探讨两个年龄段腰椎间盘突出的病因。方法：收集40例腰椎间盘突出症患者的突出腰椎间盘髓核标本，青少年组18例，年龄11～25岁，平均20.6±3.4岁；中老年组22例，年龄40～72岁，平均48.0±10.3岁。 HE染色观察标本退变情况，免疫组化染色检测MMP-3、IgG和CD68的表达，光学显微镜下观测并计录数据。结果：标本HE染色提示多数（17/22）中老年组腰椎间盘存在明显退变，青少年组多数椎间盘（13/18）退变不明显或无退变。 MMP-3阳性率青少年组（33.33%）低于中老年组（81.82%）；IgG阳性率青少年组（66.67%）高于中老年组（31.82%）；CD-68阳性率青少年组（83.33%）高于中老年组（45.45%），两组MMP-3、IgG和CD68的表达阳性率比较，差异均有统计学意义（P<0.05）。结论：免疫和炎症反应可能是青少年腰椎间盘突出的重要病因，而中老年腰椎间盘突出可能主要与退变有关。
목적：비교세포인자기질금속단백매3（matrix metalloproteinases 3，MMP-3）、IgG화CD68재청소년여중노년환자돌출요추간반조직중적표체，탐토량개년령단요추간반돌출적병인。방법：수집40례요추간반돌출증환자적돌출요추간반수핵표본，청소년조18례，년령11～25세，평균20.6±3.4세；중노년조22례，년령40～72세，평균48.0±10.3세。 HE염색관찰표본퇴변정황，면역조화염색검측MMP-3、IgG화CD68적표체，광학현미경하관측병계록수거。결과：표본HE염색제시다수（17/22）중노년조요추간반존재명현퇴변，청소년조다수추간반（13/18）퇴변불명현혹무퇴변。 MMP-3양성솔청소년조（33.33%）저우중노년조（81.82%）；IgG양성솔청소년조（66.67%）고우중노년조（31.82%）；CD-68양성솔청소년조（83.33%）고우중노년조（45.45%），량조MMP-3、IgG화CD68적표체양성솔비교，차이균유통계학의의（P<0.05）。결론：면역화염증반응가능시청소년요추간반돌출적중요병인，이중노년요추간반돌출가능주요여퇴변유관。
Objectives: To compare the expressions of cytokines MMP-3 (matrix metalloproteinases, MMPs), IgG and CD68 in the herniated nuclea pulposus between young and elder patients, and to explore the patho-genesis of lumbar intervertebral disc herniation in the both aged patients. Methods: Disc samples from 40 patients with lumbar intervertebral disc herniation were collected. The patients were grouped as the young group, including 18 patients, with an avereage age of 20.6 ±3.4 years; the elder group, 22 patients, with the avereage age of 48.0±10.3 years. Disc degeneration was detected by HE staing. The expressions of MMP-3, IgG and CD68 was detected by immunohistochemistry. Then data were collected and measured by optical mi-croscope. Results: Discs in the elder group showed degeneration by HE staing, the opposite for the young group, even no degenerative change was noted. There were less expressions of MMP-3 in young group (33.33%) than elder group (81.82%), more expressions of IgG in young group (66.67%) than elder group (31.82%), and more expressions of CD68 in young group(83.33%) than elder group(45.45%). Positive expres-sions of MMP-3, IgG and CD68 in two groups were different. Conclusions: Immunative and inflammative reaction maybe the main mechanism inducing disc herniation in the young, while in the elderly, disc degen-eration maybe the main cause.