CAJ | 학술논문

目的：腰椎间盘退变动物模型是研究人体椎间盘退变的机制及治疗方法中不可或缺的部分，目前腰椎间盘退变模型研究以小型动物为主，其椎间盘解剖结构与人体差异明显。山羊腰椎间盘解剖结构与人体相似，本研究用微创手术方法建立山羊腰椎间盘损伤退变模型，探索一种新的大型动物腰椎间盘退变造模方法。方法20只成年波尔多山羊随机分为腰椎微创造模组（A 组）、腰椎假手术组（B 组）。术前 A、B 组使用 MRI 测量腰椎间盘原始数值，腰椎微创造模组（A 组）使用全内窥镜腰椎微创手术方法制造腰椎间盘退变模型，腰椎假手术组使用相同操作而不损伤腰椎间盘。术后2个月复查腰椎 MRI，动物空气栓塞处死后获取腰椎间盘标本，并进行组织固定、切片、染色。术前及术后按 Videman 椎间盘退变等级、Zhang Y 的山羊动物椎间盘组织退变分级标准比较两组之间腰椎 MRI 影像学及细胞组织形态学评分，并用反转录聚合酶链式反应（reverse transcriotion-polymerase chain reaction，rt-PCR）法检测腰椎间盘髓核组织中缺氧诱导因子（hypoxia inducible factor-1，HIF-1）、肿瘤坏死因子-α（tumor necrosis factor，TNF-α）、转化生长因子-β（transforming growth factor-β，TGF-β）、核因子-κB（nuclear factor-κB，NF-κB）、白介素-1（interleukin-1，IL-1）基因表达差异。结果腰椎微创造模组（A 组）、腰椎假手术组（B 组）经比较，MRI 影像学评分差异明显，差异具有统计学意义（P ﹤0.05）；细胞组织形态评分差异明显，差异具有统计学意义（P ﹤0.05）。HIF-1基因表达在两组之间差异显著，差异具有统计学意义（P ﹤0.01）；TNF-a、TGF-β、IL-1基因表达差异具有统计学意义（P ﹤0.05）；NF-κB 表达在两组之间差异无统计学意义（P ﹥0.05）。结论腰椎微创造模组（A 组）、腰椎假手术组（B 组）腰椎间盘 MRI 及组织形态学差异显著，从影像学及组织学上说明全内窥镜微创造模法成功建立波尔多山羊腰椎间盘退变动物模型。两组山羊 HIF-1、TNF-a、TGF-β、IL-1基因表达差异从分子角度证明山羊腰椎间盘退变微创动物模型造模成功。目的：腰椎間盤退變動物模型是研究人體椎間盤退變的機製及治療方法中不可或缺的部分，目前腰椎間盤退變模型研究以小型動物為主，其椎間盤解剖結構與人體差異明顯。山羊腰椎間盤解剖結構與人體相似，本研究用微創手術方法建立山羊腰椎間盤損傷退變模型，探索一種新的大型動物腰椎間盤退變造模方法。方法20隻成年波爾多山羊隨機分為腰椎微創造模組（A 組）、腰椎假手術組（B 組）。術前 A、B 組使用 MRI 測量腰椎間盤原始數值，腰椎微創造模組（A 組）使用全內窺鏡腰椎微創手術方法製造腰椎間盤退變模型，腰椎假手術組使用相同操作而不損傷腰椎間盤。術後2箇月複查腰椎 MRI，動物空氣栓塞處死後穫取腰椎間盤標本，併進行組織固定、切片、染色。術前及術後按 Videman 椎間盤退變等級、Zhang Y 的山羊動物椎間盤組織退變分級標準比較兩組之間腰椎 MRI 影像學及細胞組織形態學評分，併用反轉錄聚閤酶鏈式反應（reverse transcriotion-polymerase chain reaction，rt-PCR）法檢測腰椎間盤髓覈組織中缺氧誘導因子（hypoxia inducible factor-1，HIF-1）、腫瘤壞死因子-α（tumor necrosis factor，TNF-α）、轉化生長因子-β（transforming growth factor-β，TGF-β）、覈因子-κB（nuclear factor-κB，NF-κB）、白介素-1（interleukin-1，IL-1）基因錶達差異。結果腰椎微創造模組（A 組）、腰椎假手術組（B 組）經比較，MRI 影像學評分差異明顯，差異具有統計學意義（P ﹤0.05）；細胞組織形態評分差異明顯，差異具有統計學意義（P ﹤0.05）。HIF-1基因錶達在兩組之間差異顯著，差異具有統計學意義（P ﹤0.01）；TNF-a、TGF-β、IL-1基因錶達差異具有統計學意義（P ﹤0.05）；NF-κB 錶達在兩組之間差異無統計學意義（P ﹥0.05）。結論腰椎微創造模組（A 組）、腰椎假手術組（B 組）腰椎間盤 MRI 及組織形態學差異顯著，從影像學及組織學上說明全內窺鏡微創造模法成功建立波爾多山羊腰椎間盤退變動物模型。兩組山羊 HIF-1、TNF-a、TGF-β、IL-1基因錶達差異從分子角度證明山羊腰椎間盤退變微創動物模型造模成功。
목적：요추간반퇴변동물모형시연구인체추간반퇴변적궤제급치료방법중불가혹결적부분，목전요추간반퇴변모형연구이소형동물위주，기추간반해부결구여인체차이명현。산양요추간반해부결구여인체상사，본연구용미창수술방법건립산양요추간반손상퇴변모형，탐색일충신적대형동물요추간반퇴변조모방법。방법20지성년파이다산양수궤분위요추미창조모조（A 조）、요추가수술조（B 조）。술전 A、B 조사용 MRI 측량요추간반원시수치，요추미창조모조（A 조）사용전내규경요추미창수술방법제조요추간반퇴변모형，요추가수술조사용상동조작이불손상요추간반。술후2개월복사요추 MRI，동물공기전새처사후획취요추간반표본，병진행조직고정、절편、염색。술전급술후안 Videman 추간반퇴변등급、Zhang Y 적산양동물추간반조직퇴변분급표준비교량조지간요추 MRI 영상학급세포조직형태학평분，병용반전록취합매련식반응（reverse transcriotion-polymerase chain reaction，rt-PCR）법검측요추간반수핵조직중결양유도인자（hypoxia inducible factor-1，HIF-1）、종류배사인자-α（tumor necrosis factor，TNF-α）、전화생장인자-β（transforming growth factor-β，TGF-β）、핵인자-κB（nuclear factor-κB，NF-κB）、백개소-1（interleukin-1，IL-1）기인표체차이。결과요추미창조모조（A 조）、요추가수술조（B 조）경비교，MRI 영상학평분차이명현，차이구유통계학의의（P ﹤0.05）；세포조직형태평분차이명현，차이구유통계학의의（P ﹤0.05）。HIF-1기인표체재량조지간차이현저，차이구유통계학의의（P ﹤0.01）；TNF-a、TGF-β、IL-1기인표체차이구유통계학의의（P ﹤0.05）；NF-κB 표체재량조지간차이무통계학의의（P ﹥0.05）。결론요추미창조모조（A 조）、요추가수술조（B 조）요추간반 MRI 급조직형태학차이현저，종영상학급조직학상설명전내규경미창조모법성공건립파이다산양요추간반퇴변동물모형。량조산양 HIF-1、TNF-a、TGF-β、IL-1기인표체차이종분자각도증명산양요추간반퇴변미창동물모형조모성공。
Objective To make goat model of lumbar intervertebral disc degeneration to explorer a new method to create large animal model. Methods Twenty Bordeaux goats were divided to two groups. Group A underwent full-endoscopic tech-nique of minimally invasive surgery,the group B is sham-operation group. Original dates of all lumbar intervertebral disc were detected by MRI before operation. Full-endoscopic technique of minimally invasive surgery was used to make animal model of lumbar intervertebral disc degeneration. Sham-operation group accape the same technique but the structure of lumbar interverte-bral disc was not injured. Two months later,MRI test was taken again and lumbar intervertebral discs were harvested after ani-mals sacrificed. Comparation of MRI scores,histology scores and gene expression including HIF-1、TNF-a、TGF-β、NFκB、IL-1in nucleus pulposus tissue were taken in these two groups. Results There were statistically significant differences in MRI scores and histology scores of these two groups(P ﹤ 0. 05). TNF-a、TGF-β、IL-1 gene expression also had a significant differ-ence in these two groups,further more the gene expression of HIF-1 had a statistically significant difference(P ﹤ 0. 01). The gene expression of TNF-a between group A and group B had no statistically difference.(P ﹥ 0. 05)Conclusion The statisti-cally significant differences in MRI scores and histology scores illustrate that full-endoscopic technique of minimally invasive surgery successfully estabilish a goat model of lumbar intervertebral disc degeneration. Also the significant different gene ex-pression of HIF-1、TNF-a、TGF-β、IL-1in nucleus pulposus tissue of the two groups further prove this conclusion with molecule evidence.