特发性脊柱侧凸椎旁肌组织中神经型及诱导型一氧化氮合酶表达的研究

摘要

背景:特发性脊柱侧凸病因不清楚,目前关于其病因及发病机制存在诸多争论.椎旁肌在脊柱侧凸中作用已经成为研究热点.目的:比较特发性脊柱侧凸胸椎椎旁肌肉中神经型一氧化氮合酶和诱导型一氧化氮合酶表达与定位.设计:以诊断为依据设立对照的实验研究.地点与对象:北京协和医院骨科收治胸椎侧凸畸形患者10例,其中男8例,女2例;平均年龄14岁.胸腰椎爆裂骨折患者2例做对照.干预:手术中,于T6～T11椎体水平的侧弯顶椎水平取双侧椎旁肌,部分组织甲醛固定,行苏木精-伊红(HE)染色;其余组织冰冻,进行免疫组织化学及Western印迹杂交.主要观察指标:脊柱侧凸患者及正常椎旁肌组织中神经型一氧化氮合酶和诱导型一氧化氮合酶的表达情况.?结果:脊柱侧凸患者脊柱凸侧椎旁肌组织与凹侧椎旁肌组织和正常对照相比,神经型一氧化氮合酶的表达明显下调,诱导型一氧化氮合酶的表达也有所下调,但诱导型一氧化氮合酶表达总量较低.Western印迹检测得到同样的结果.结论:脊柱侧凸患者双侧椎旁肌神经型一氧化氮合酶蛋白表达不均衡,可能与特发性脊柱侧凸发生存在密切关系,诱导型一氧化氮合酶可能在特发性脊柱侧凸的发生中不发挥作用.%BACKGROUND: There are many conflicting theories on the etiology and pathogenesis of idiopathic scoliosis. The effect of paraspinal muscles in adolescent idiopathic scoliosis has become a hot topic in the researches.OBJECTIVE: To compare the expression and localization of neuronal nitric oxide synthase(nNOS) and inducible nitric oxide synthase(iNOS) of the thoracic spinal musculature on convex side with those on the concave side in the idiopathic scoliosis.DESIGN: A randomized controlled trial based on the diagnosis.SETTING and PARTICIPANTS: Ten patients with thoracic spinal scoliosis admitted by the Department of Orthopaedic Surgery, Peking Union Medical College Hospital were selected, of whom there were 8 males and 2 females with a mean age of 14 years old. Two patients with thoracic lumbar spinal bursting fracture were selected into control group.INTERVENTIONS: Muscle biopsies were taken bilaterally during surgery from the superficial multifidus muscle at the apex of the curve between T6and T11 thoracic vertebral levels. Part of the tissue was fixed in formalin and stained with hematoxylin and eosin(HE); the remaining tissue was snap frozen for immunohistochemistry and Western blotting.MAIN OUTCOME MEASURES: The expressions of nNOS and iNOS in paraspinal musculauture in normal and scoliosis patients RESULTS: The expressions of nNOS in both convex and concave sides of paraspinal musculature in scoliosis patients were significantly decreased as well as iNOS compared with that of control group, and the quantity of the expression of iNOS relatively low. Same results were achieved in Western blotting.CONCLUSION: There is unbalanced expression of nNOS in paraspinal muscles on different side in scoliosis patients, which might closely relate with the genesis of idiopathic scoliosis. iNOS might not have a role in the genesis of idiopathic scoliosis.