Objective To explore the expression and significance of MMP-1 and TIMP-1 in the nucleus pulposus and anulus fibrosus of intervertebral disc with different lesions.Methods From August 2014 to August 2016,34 cases of lumbar disc herniation (the observation group) and 34 case of surgical removal of intervertebral disc in patients with vertebral trauma caused by sudden trauma (the control group) in our hospital were stuided.The nucleus pulposus and anulus fibrosus of intervertebral disc were separated,and the expression of MMP-1 and TIMP-1 were detected by immunohistochemistry.The relationship between MMP-1 and TIMP-1 expression and intervertebral disc degeneration was analyzed.Results The MMP-1 and TIMP-1 expression of nucleus pulposus in the observation group were significantly higher than those in the control group(P>0.05);and the MMP-1 and TIMP-1 expression of nucleus pulposus decreased successively in prominent type,extrusion type,free type lumbar intervertebral disc degeneration(P<0.05).The MMP-1 and TIMP-1 expression of anulus fibrosus in the observation group were significantly higher than those in the control group(P>0.05);and the MMP-1 and TIMP-1 expression of anulus fibrosus decreased successively in prominent type,extrusion type,free type lumbar intervertebral disc degeneration(P<0.05).Patients with high expression of MMP-1 and TIMP-1 in nucleus pulposus and anulus fibrosus had more risk of degenerative disc disease(P<0.05).As a sensitivity prediction of intervertebral disc degeneration,the sensitivity of MMP-1 was 82.35% while the specificity was 94.11%,and the sensitivity of TIMP-1 was 79.41% while the specificity was 88.24%.The prediction sensitivity of intervertebral disc degeneration was 90.91% and the specificity was 97.14% when combined MMP-1 with TIMP-1.Conclusion The expression of MMP-1 and TIMP-1 in the nucleus pulposus and anulus fibrosus of intervertebral disc degeneration was significantly increased,which is of great clinical significance in the diagnosis of intervertebral disc degeneration.%目的 研究椎间盘病变椎间盘髓核及纤维环MMP-1及TIMP-1表达变化及意义.方法 选取我院2014年8月至2016年8月收治的34例椎间盘突出症患者作为观察组,将同期34例突发创伤致椎体骨折手术摘除椎间盘患者作为对照组.手术分离椎间盘髓核及纤维环,用免疫组化法检测MMP-1、TIMP-1表达,分析MMP-1、TIMP-1表达与椎间盘退行性病变的关系.结果观察组髓核MMP-1、TIMP-1表达量明显高于对照组(P<0.05);且在突出型、脱出型、游离型椎间盘退变中,髓核MMP-1、TIMP-1表达量依次下降(P<0.05).观察组纤维环MMP-1、TIMP-1表达量明显高于对照组(P<0.05);且在突出型、脱出型、游离型椎间盘退变中,纤维环MMP-1、TIMP-1表达量依次下降(P<0.05).髓核及纤维环MMP-1、TIMP-1高表达,发生椎间盘退行性病变的风险明显高于MMP-1、TIMP-1低表达者(P<0.05).MMP-1作为预测椎间盘退行性病变的灵敏度为82.35%,特异度为94.11%;TIMP-1作为预测椎间盘退行性病变的灵敏度为79.41%,特异度为88.24%;联合二者,其预测椎间盘退行性病变的灵敏度为90.91%,特异度为97.14%.结论 椎间盘退行性病变患者椎间盘髓核及纤维环MMP-1、TIMP-1的表达明显增高,对协助诊断椎间盘退行性病变具有重要临床意义.
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