腰椎小关节SP、CGRP免疫反应神经分布及其与腰椎退变的相关性研究

目的　观察小关节SP、CGRP神经正常分布和在关节退变时分布的变化 ,探讨椎间盘结构和功能改变对小关节的影响和小关节肽能神经在腰椎小关节退变发生中的作用。方法　通过间盘移植建立腰椎小关节退变模型 ,用免疫组化染色观察小关节SP、CGRP神经正常分布和在关节退变时分布的变化。结果　SP和CGRP -IR神经纤维在小关节内的定位与分布基本一致 ,小关节含SP/CGRP神经主要存在于关节囊内 ,另外在小关节软骨下骨区亦有少量独立走行的SP/CGRP纤维。腰椎小关节退变时 ,关节囊及软骨下骨区 ,SP -IR、CGRP -IR神经纤维减少。结论　SP、CGRP可能参与关节退变及腰痛的发生 ,小关节在腰腿痛发生中起重要作用。

The distributions of substance P (SP) and calcitonin gene-related peptide (CGRP) in facet joints and its relation with joints degeneration

Objectives To investigate the distributions of substance P (SP) and calcitonin gene-related peptide (CGRP) in normal and degenerative facet joints.Methods With immunohistochemical approach, the SP,CGRP-immunoreactive fibers in the normal and degenerative facet joints were observed.Results In the normal facet joint,SP,CGRP immunoreactive nerve fibers distributed in joint capsule and subchondral bone area,most of them were located in facet capsule.The fibers were also foundin plical tissue of the capsule .They were not all associated with large blood vessels, some of them run freely in the stroma.The density of SP-,CGRP- containing fibers decreased in degenerative joint capsule.Conclusion The observation provided morphological basis for back pain,implied that the SP,CGRP-immunoreactive fibers might involve in facet degeneration and might be an important source of the lower back pain.