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1、临床医学论文-项韧带钙化与颈椎病黄韧带退变的相关性硏究作者：王长峰，贾连顺,魏海峰，施政，杨诚，马俊民【关键词】项韧带摘要：〔目的〕探讨不同节段项韧带钙化与脊髓型颈椎病黄韧带退变的相关性。〔方法〕取脊髓型颈椎病患者黄韧带192块（项韧带钙化28个节段，相应黄韧带标本56块）和青壮年颈椎创伤（非颈椎病）的黄韧带标本38块。对切除的黄韧带标本进行测量及组织学检查；用Woessner法测定其胶原含量；用盐析法对黄韧带中的I型/II型胶原含量比进行测定；对黄韧带厚度与拜脯氨酸、胶原干粉含量及I型/U型胶原含量比进行相关性硏究。〔结论〕颈椎病组11项韧带钙化相应节段的黄韧带弹力纤维
2、含量下降，胶原纤维含量增加，弹力纤维发生排列紊乱。实验组中C4、5、C5、6项韧带钙化相应的节段黄韧带厚度、疑脯氨酸含量、I型/II型胶原含量比较阴性对照组有显著差异（P<005）；而C3、4、C6、7项韧带钙化相应节段的黄韧带上述扌旨标则无显著差异（P〉005）。〔结论〕C4、5、C5、6节段的项韧带钙化与颈椎病黄韧带的退变有相关性；上述节段的项韧带钙化提示存在应力异常分布，可能会加剧黄韧带退变，进而影响脊髓型颈椎病的发病进程。关键词：项韧带；钙化；黄韧带；退变；相关性Abstract:[Objective]Tostudytherelationshipbetweenos
3、sificationof1igamentumnuchae(LN)anddegenerationof1igamenlumflavon(LF)ofcervicalspondyloticmyelopathy(CSM)〔Method〕FiftysixcervicalLFsamplesfromCSMpatientofC3~7inrelationtothestageofossificationofLNsamples(experimentalgroup,EG)and38samplesofcorrespondingligamentfrompatientwithcervicalverteb
4、raltrauma(CVT)(controlgroup,CXj)wereobtainedThicknessofLFwasmeasured,theirpathologicalchangewasexaminedbymicroscopy,contentofcollagenandkydrolyprolineandtheratiooftypeI/typeUcol1agenweredeterminedbyWoessnersmethodandsettingSaltingoutmethodThecorrelationamongthethicknessofdegenerativeLF,th
5、eratiooftypeI/typeIIcollagen,thecontentofcollagenandhydrokyproline,andarrangementdisorderofLFinrelationtotheossificationstageofLNwereanalyzed[Result〕TnEG,ascomparedwithinCG,thereshowedadecreaseofelasticfibre,decreaseofratiotypeI/typeUcollagenduetosignificantincreaseoftypeHcollagen,increas
6、ecollagencontentanddisorderarrangementofLFInrelationtotheossificationofLN,abovechangesweremoremarkedinLFofC4、5,C5、6,thanthatofC3、4,C6、7(P<005)〔Conclusion]ThedegenerationofLFiscorrelatedwithossificationstageofC4、5,C5、6LN,ThcossificationofLN,thatresultedinabnormaldistributeofstressinLF,mayb
7、eamainetiologicfactortoCSMKeywords:Ligamentumflavon;Ligamentumnuchac;Dcgcncration;Ossification;Ccrvicalspondyloticmyelopathy随着对脊髓型颈椎病发病机理的深入硏究，学者们认为颈椎病的发病除与三关节复合体的退变有关外,还与颈椎韧带及肌肉系统的动力失衡有关〔1〕。项韧带钙化在脊髓型颈椎病发展进程中的意义目前缺乏较深入的硏究。不同节段项韧带钙化与脊髓型颈椎病黄韧带退变的关系値得探讨。1资料和方法11一般资料自20
