Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China.
Orthop Surg. 2009 Nov;1(4):317-21. doi: 10.1111/j.1757-7861.2009.00052.x.
To determine the correlation between the degree of radiculalgia and counts of T lymphocyte subsets in the peripheral blood of patients with lumbar disc herniation.
Forty-nine patients with lumbar disc herniation (group A) were divided into three subgroups according to Visual Analogue Scale (VAS) pain scores (group A(1): n= 12, VAS 0-4.0; A(2): n= 24, VAS 4.1-7.0; A(3): n= 13, VAS 7.1-10.0. Twenty health blood donors who volunteered to be involved in the study comprised the control group (group B). Peripheral blood counts of various T lymphocyte subsets were measured in each group.
(i) The counts of CD4+ T and CD4+/CD8+ lymphocytes were higher in group A than in group B, and the difference between the two groups was statistically significant (P < 0.05). There were also statistically significant differences between group A and group B in the counts of CD3+ and CD8+ T lymphocytes (P < 0.05); (ii) There was no correlation between the VAS scores and the counts of CD3+ T lymphocytes (r= 0.194, P > 0.05). A strong significant correlation was observed between the VAS scores and counts of CD4+ T lymphocytes (r= 0.542, P < 0.05), CD4+/CD8+ (r= 0.468, P < 0.05), which increased with increasing VAS scores in the three subgroups of group A (P < 0.05). However there was a significant negative linear correlation between CD8+ T lymphocyte counts and pain scores (r=-0.462, P < 0.05).
Our results suggest that changes in T lymphocyte subsets in peripheral blood take place after prolapse of lumbar intervertebral discs. The current results may provide support for involvement of immunologic mechanisms in low back pain secondary to herniation of the lumbar disc. T lymphocytes may play an important role in the development of symptoms in patients with lumbar intervertebral disc herniation.
确定腰椎间盘突出症患者外周血 T 淋巴细胞亚群计数与神经根痛程度的相关性。
49 例腰椎间盘突出症患者(A 组)根据视觉模拟评分量表(VAS)疼痛评分分为 3 个亚组(A(1)组:n=12,VAS0-4.0;A(2)组:n=24,VAS4.1-7.0;A(3)组:n=13,VAS7.1-10.0)。20 名自愿参与研究的健康献血者为对照组(B 组)。测量各组外周血各种 T 淋巴细胞亚群的计数。
(i)A 组的 CD4+T 细胞和 CD4+/CD8+淋巴细胞计数高于 B 组,两组间差异有统计学意义(P<0.05);A 组与 B 组的 CD3+和 CD8+T 淋巴细胞计数也有统计学差异(P<0.05);(ii)VAS 评分与 CD3+T 淋巴细胞计数无相关性(r=0.194,P>0.05)。VAS 评分与 CD4+T 淋巴细胞计数呈强显著相关(r=0.542,P<0.05),与 CD4+/CD8+呈显著正相关(r=0.468,P<0.05),A 组三个亚组的 VAS 评分随 CD4+T 淋巴细胞、CD4+/CD8+计数的增加而增加(P<0.05)。然而,CD8+T 淋巴细胞计数与疼痛评分呈显著负线性相关(r=-0.462,P<0.05)。
我们的结果表明,腰椎间盘突出后外周血 T 淋巴细胞亚群发生变化。目前的结果可能为免疫机制参与腰椎间盘突出症所致腰痛提供支持。T 淋巴细胞可能在腰椎间盘突出症患者症状的发展中起重要作用。