CAJ | 학술논문

目的研究应用生长分化因子-5(growth differentiation factor-5,GDF-5)和纤维蛋白凝胶复合物局部注射治疗兔腰椎间盘损伤的效果. 方法选用健康新西兰白兔40只,显露L3、4、L4/5、L5/6椎间盘,使用20号穿刺针进行椎间盘穿刺,L3/4椎间盘穿刺后注入GDF-5和纤维蛋白凝胶复合物(复合物组),L4/5椎间盘穿刺后注入纤维蛋白凝胶(纤维蛋白凝胶组),L5/6椎间盘穿刺后不进行处理(空白对照组),分别于术后2周行腰椎计算机X线片检查、MRI检查、髓核内蛋白多糖含量测定、椎间盘组织学检查,了解各组椎间盘的退变情况. 结果术后2,4,8,12周X线片示三组椎间盘高度指数(disc height index,DHI)逐渐下降,但复合物组DHI下降速度低于其他两组(P＜0.05).MRI显示三组椎间盘信号值均随时间推移进行性下降,但复合物组的信号值下降速度低于其他两组(P＜0.05).术后4周复合物组、空白对照组和纤维蛋白凝胶组椎间盘髓核内蛋白多糖含量分别为6.3±0.4,5.9±0.4,5.8±0.3,复合物组含量高于其他两组(P＜0.05).组织学检查显示,术后2周复合物组、空白对照组和纤维蛋白凝胶组的组织学评分分别为5.28±0.41,7.54 ±0.53,7.21 ±0.44,复合物组评分明显低于其他两组(P＜0.05). 结论应用GDF-5和纤维蛋白凝胶复合物局部注射能促进椎间盘的修复,延缓椎间盘的退变.
목적 연구응용생장분화인자-5(growth differentiation factor-5,GDF-5)화섬유단백응효복합물국부주사치료토요추간반손상적효과. 방법 선용건강신서란백토40지,현로L3、4、L4/5、L5/6추간반,사용20호천자침진행추간반천자,L3/4추간반천자후주입GDF-5화섬유단백응효복합물(복합물조),L4/5추간반천자후주입섬유단백응효(섬유단백응효조),L5/6추간반천자후불진행처리(공백대조조),분별우술후2주행요추계산궤X선편검사、MRI검사、수핵내단백다당함량측정、추간반조직학검사,료해각조추간반적퇴변정황. 결과 술후2,4,8,12주X선편시삼조추간반고도지수(disc height index,DHI)축점하강,단복합물조DHI하강속도저우기타량조(P＜0.05).MRI현시삼조추간반신호치균수시간추이진행성하강,단복합물조적신호치하강속도저우기타량조(P＜0.05).술후4주복합물조、공백대조조화섬유단백응효조추간반수핵내단백다당함량분별위6.3±0.4,5.9±0.4,5.8±0.3,복합물조함량고우기타량조(P＜0.05).조직학검사현시,술후2주복합물조、공백대조조화섬유단백응효조적조직학평분분별위5.28±0.41,7.54 ±0.53,7.21 ±0.44,복합물조평분명현저우기타량조(P＜0.05). 결론 응용GDF-5화섬유단백응효복합물국부주사능촉진추간반적수복,연완추간반적퇴변.
Objective To investigate the result of local injection of growth differentiation factor-5 (GDF-5) and fibrin gel for treatment of lumbar disc injury in rabbits.Methods Lumbar puncture with a 20-gauge needle was performed at L3/4,L4/5,and L5/6 discs of 40 New Zealand white rabbits.After needle puncture,L3/4 discs were injected with GDF-5 and fibrin gel (compound group) ; L4/5 discs fibrin gel (fibrin gel group) ; L5/6 discs nothing (blank control group).Two weeks later,intervertebral disc degeneration in each group was observed via radiography,MRI and nucleus proteoglycan content detection and histological examination.Results At postoperative 2-,4-,8-,and 12-weeks,X-ray films revealed a gradual decrease in disc height index (DHI) among the three groups,but the decreasing velocity was lower in compound group than in other two groups (P ＜ 0.05).On MRI,the signal of intervebral discs among the three groups diminished progressively with time,but a relatively lower decreasing was observed in compound group (P ＜ 0.05).At postoperative 4-week,proteoglycan content of the nucleus pulposus was (6.3-± 0.4) in compound group,higher than (5.9-0.4) in blank control group and (5.8-± 0.3)in fibrin gel group (P ＜0.05).At postoperative 2-week,histological evaluation showed (5.28 ±0.41)points in compound group,lower than (7.54 ± 0.53) points in blank control group and (7.21 ± 0.44)points in fibrin gel group (P ＜ 0.05).Conclusion Local injection of GDF-5 and fibrin gel facilitates the restoration of the injured discs and delays further disc degeneration.