CAJ | 학술논문

目的：对比观察破裂型与未破裂型腰椎间盘突出组织的超微结构，研究破裂型椎间盘组织易于发生重吸收的可能机制。方法选取30例腰椎间盘突出症患者的手术标本，依术中是否突破后纵韧带分为破裂型(14例)和未破裂型(16例)，规范处理后制成超薄切片，利用透射电镜观察。结果破裂型椎间盘细胞密度低，胞周胶原纤维短缩，细胞呈多角形或类似圆形，细胞器代谢活跃，“空泡征”明显；未破裂型椎间盘胞周胶原纤维排列较规则，细胞呈长梭形或椭圆形，细胞膜皱褶，细胞器少，出现核仁溶解等细胞凋亡指征。结论破裂型腰椎间盘突出组织突破后纵韧带进入硬膜外腔后，获得营养恢复部分代谢途径，胞浆逐渐丰富，细胞由长梭形又恢复至多角形或圆形，高尔基体、粗面内质网等部分细胞器被激活，“空泡样”结构明显；同时发生免疫自噬和凋亡现象，有助于突出组织重吸收。
목적：대비관찰파렬형여미파렬형요추간반돌출조직적초미결구，연구파렬형추간반조직역우발생중흡수적가능궤제。방법선취30례요추간반돌출증환자적수술표본，의술중시부돌파후종인대분위파렬형(14례)화미파렬형(16례)，규범처리후제성초박절편，이용투사전경관찰。결과파렬형추간반세포밀도저，포주효원섬유단축，세포정다각형혹유사원형，세포기대사활약，“공포정”명현；미파렬형추간반포주효원섬유배렬교규칙，세포정장사형혹타원형，세포막추습，세포기소，출현핵인용해등세포조망지정。결론파렬형요추간반돌출조직돌파후종인대진입경막외강후，획득영양회복부분대사도경，포장축점봉부，세포유장사형우회복지다각형혹원형，고이기체、조면내질망등부분세포기피격활，“공포양”결구명현；동시발생면역자서화조망현상，유조우돌출조직중흡수。
Objective To compare ruptured and unruptured lumbar disc tissue ultrastructure to determine reabsorption mechanism. Methods 30 cases of patients with lumbar disc herniation surgical specimens, according to intraopera-tive findings were divided into 14 cases of ruptured and unruptured 16 cases. Treatment was made by the norms ultra-thin sections, the use of transmission electron microscopy. Results Ruptured disc low cell density,cell weeks colla-gen fibers shortening,cells were polygonal or similar round organelles metabolically active,“vacuole sign” clearly;un-ruptured disc periplasmic more regular arrangement of collagen fibers,elongated cells spindle-shaped or oval,mem-brane folds, small organelles,cells appeared indications dissolution nucleolus. Conclusions Lumbar disc rupture af-ter the break longitudinal ligament tissue into the epidural space,access to nutritious part of the metabolic pathway re-store gradually abundant cytoplasm,the cell has returned from long fusiform to polygonal or circular,Golgi apparatus, rough endoplasmic reticulum other parts of the cell is activated,“vacuoles” obvious structure;simultaneous immuno-logical autophagy and apoptosis,help to highlight the organization reabsorption.