CAJ | 학술논문

目的：研究兔椎间隙感染后不同时间点，椎体软骨终板及髓核组织学改变、生物化学成分变化与椎间盘弥散功能改变的相关性。方法取新西兰兔60只，制作椎间隙感染模型。在术后1、2、4、8、12周，每次随机取椎间隙感染模型兔各8只、对照组兔4只。采用HE染色观察软骨终板组织形态学，免疫组化测定软骨终板下血管内皮生长因子（VEGF）表达，RT-PCR测定髓核组织中Ⅱ型胶原蛋白、aggrecan蛋白mRNA表达，连续动态增强MRI检测椎间盘弥散功能。结果椎间隙感染后，软骨终板上出现新生毛细血管，VEGF 表达逐渐增多，髓核组织内蛋白多糖及Ⅱ型胶原含量减少，软骨终板弥散功能逐渐增强；感染后4周时，新生毛细血管达到最多，VEGF表达最多，弥散功能达到最佳，4周后逐渐减少，在感染后4周时，蛋白多糖及Ⅱ型胶原破坏达到最强，4周后基质破坏有所修复。软骨终板VEGF表达与椎间盘弥散功能呈正相关关系（r＝0.704，P＝0.000）；蛋白多糖mRNA表达与椎间盘弥散功能呈负相关关系（r＝-0.480，P＝0.000）。结论椎间隙感染后椎间盘弥散功能处于一个动态变化中，在感染后4周时弥散功能达到最佳。椎间隙感染后软骨终板VEGF表达与椎间盘弥散功能呈正相关关系，髓核中蛋白多糖mRNA表达与椎间盘弥散功能呈负相关关系。
목적：연구토추간극감염후불동시간점，추체연골종판급수핵조직학개변、생물화학성분변화여추간반미산공능개변적상관성。방법취신서란토60지，제작추간극감염모형。재술후1、2、4、8、12주，매차수궤취추간극감염모형토각8지、대조조토4지。채용HE염색관찰연골종판조직형태학，면역조화측정연골종판하혈관내피생장인자（VEGF）표체，RT-PCR측정수핵조직중Ⅱ형효원단백、aggrecan단백mRNA표체，련속동태증강MRI검측추간반미산공능。결과추간극감염후，연골종판상출현신생모세혈관，VEGF 표체축점증다，수핵조직내단백다당급Ⅱ형효원함량감소，연골종판미산공능축점증강；감염후4주시，신생모세혈관체도최다，VEGF표체최다，미산공능체도최가，4주후축점감소，재감염후4주시，단백다당급Ⅱ형효원파배체도최강，4주후기질파배유소수복。연골종판VEGF표체여추간반미산공능정정상관관계（r＝0.704，P＝0.000）；단백다당mRNA표체여추간반미산공능정부상관관계（r＝-0.480，P＝0.000）。결론추간극감염후추간반미산공능처우일개동태변화중，재감염후4주시미산공능체도최가。추간극감염후연골종판VEGF표체여추간반미산공능정정상관관계，수핵중단백다당mRNA표체여추간반미산공능정부상관관계。
Objective To explore the histology and biochemical composition changes of the cartilage end plate and nucleus pulposus during the course of the disease, and the relationship between the above changes and the diffusion function of the endplate cartilage. Methods Sixty New Zealand white rabbits were taken to make discitis model. During the period of 1, 2, 4, 8 and 12 weeks after surgery, 8 discitis rabbits and 4 controls were randomly taken. HE staining of the cartilage endplate histological morphology, immunohistochemical of vascular endothelial cells in the cartilage endplate VEGF expression, real-time polymerase chain reaction (RT-PCR) of the type Ⅱ collagen and aggrecan mRNA expression of the nucleus pulposus and continuous dynamic contrast-enhanced MRI of the diffusion function of the disc were taken. Results The newborn capillaries appeared on the cartilage endplate and the expression of VEGF increased 1-4 weeks after discitis. Proteoglycans and type Ⅱ collagen expression of the nucleus pulposus decreased and the diffusion function of the disc increased gradually. The newborn capillaries, expression of VEGF and the diffusion function achieved the best after 4 weeks and then gradually reduced with the destruction achieving strongest at 4 weeks after infection. A positive correlation existed between the expression of VEGF and the diffuse function(r=0.704, P=0.000). A negative correlation existed between the expression of proteoglycan and the diffuse function (r=-0.480, P=0.000). Conclusion The diffuse function of the intervertebral disc after discitis is in a dynamic change and achieved best in the 4 weeks. A positive correlation existed between the expression of VEGF and the diffuse function. A negative correlation existed between the expression of proteoglycans and the diffuse function.