脉冲射频降低NF-κB磷酸化水平治疗腰椎间盘突出症患者的疼痛吴大胜△ 刘炎 刘娜 宋永光 宫小文

THE INVOLVEMENT OF NF-κB IN THE TREATMENT OF PULSED RADIOFREQUENCY ON PATIENTS WITH LUMBER INTERVERTEBRAL DISC HERNIATION.

摘要:

目的 观察脉冲射频对腰椎间盘突出症的疗效,并检测其对引起疼痛的神经化学分子的影响,并探索其作用机理。方法 腰椎间盘突出症患者120例,均在X射线引导下行经皮腰椎间盘内射频调解术。根据疼痛视觉模拟评分量表(visual analogue scale,VAS)及止痛药使用情况、改良Mac Nab评价法统计患者的临床症状缓解进行评价。应用Western Blot方法检测检测治疗前、治疗后1、4、12周患者血清NF-κB p65蛋白含量的改变。结果 术后1周、6个月患者VAS评分及止痛药使用评分明显下降,与术前比较差异均有统计学意义( <0.05)；术后7 d(近期疗效)与术后6个月(远期疗效)比较,总体有效率分别为95.8％和97.3％；优良率分别为92.0％和98.3％。术前患者血清NF-κB的磷酸化水平明显上调。与术前相比,术后1 、4 、12周患者血清NF-κBp65蛋白含量明显下降,差异均有统计学意义( <0.05)。结论 盘内脉冲射频治疗腰椎间盘突出症均获得了较理想的临床疗效。脉冲射频可通过降低腰椎间盘突出症患者血清NF-κB的磷酸化水平发挥镇痛作用。

Abstract:

0bjective To investigate the clinical effect and mechanism of pulsed radiofrequency to treat herniation under DSA-guidance. Methods Sixty patients with lumbar disc herniation received pulsed radiofequency under the guidance of DSA. Clinical effects were evaluated by observing the changes of visual analogues scales(VAS),the condition of taking painkillers and by using modified Mac Nab method on postoperative day-7 and at final follow-up(6 months after surgery). The levels of NF-κB p65 in serum of patients were detected by western blot before and at weeks 1,4 and 1 2 after surgery, and the results were compared and analyzed. Results Compared with preoperative clinical data,the VAS and score of taking painkillers both dropped sharply,which reflected a significant difference compared to the previous data by statistical method( <0.05). The efficiency rate of treatment that evaluated by using modified Mac Nab was 95.8％and 97.3％respectively. The results of western blot showed that NF-κB levels significantly decreased in their serum at weeks 1, 4 and 12 after surgery than that before surgery. Conclusions It is very effective clinically to get pulsed radiofequency under DSA—guiding in reducing pain for the treatment of lumber disc herniation. Pulsed radiofequency decreased contents of NF-κB p65 in serum of patients, which may led to pain reIief.