ExperimentalResearch肩袖撕裂病人肩峰下滑囊顶部的组织学变化

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1、ExperimentalResearch肩袖撕裂病人肩峰下滑囊顶部的组织学变化作者：朱锦宇，吕宏升，朱庆生，桥本卓，信原克哉【摘要】［目的］观察肩袖撕裂病人肩峰下滑囊（subacromialbursa,SAB）顶部的组织学变化。［方法］在肩袖撕裂病人修复手术中，分别取撕裂处和远离撕裂处SAB顶部，采用组织学、免疫组织化学和电镜观察上述两处SAB的形态学变化，通过计算机图像分析系统对SAB切片的细胞数量进行定量评价，并与正常SAB比较。［结果］实验组所有肩袖撕裂病人SAB顶部，不管是取自撕裂部位还是远隔部位，均可见细胞数量和血管分布的增加，细胞

2、数量显著高于正常SAB(P<0.05)，且均未观察到炎性细胞浸润。肩袖撕裂的不同类型、SAB的不同增厚程度以及SAB是否积液，SAB细胞数量无显著性差异。超微结构可见到以B型细胞为主，细胞狭长。免疫组织化学染色也证实肩袖撕裂病人SAB顶部主要系B型滑膜细胞。［结论］肩袖撕裂病人SAB顶部的细胞数量的增加是一种反应性的增加，而不是真正的炎症，而且这种反应是广泛性的。SAB的变化系肩袖撕裂引起的继发反应。【关键词】肩关节；滑囊；肩袖Abstract：［Objective］Toinvestigatethemorphologicalchange

3、softheroofofthesubacromialbursaandtheextentof16involvementofthesubacromialbursaafterrotatorcufftear.［Method］Fortheexperimentalgroup,theroofofthesubacromialbursawasobtainedfrompatientswithrotatorcufftearbothatthetearsiteand2.5to3.0cmdistaltothetearsiteduringsurgeryofrotatorc

4、uffrepair.Forthecontrolgroup,theroofofthesubacromialbursawasobtainedduringsurgeryofrecurrentshoulderdislocationorhumeralshaftfractureattheexposuresite.Thespecimenswereprocessedforhistologicalstaining,immunohistochemicalanalysisandfortransmissionelectronmicroscopy.Thenumbero

5、fcellswerequantitatedbycountingcellswithblue-stainednucleusinthesubacromialbursausingacomputerimageanalysissystem.［Result］Thenumberofcellsincreasedsignificantlyintheroofofthesubacromialbursaobtainedfrombothsites,thetearsiteandthedistalsite,inthepatientswithrotatorcufftear,c

6、omparedwiththenormalbursa(P<0.05byANOVA).However,therewasnodifferenceinthebursalreactionamongtherotatorcuffteartype,thebursathicknessandthepresenceoffluidinthebursa.ThegreatmajorityofcellsweretypeBcellsobservedundertransmissionelectronmicroscopyandconfirmedbyimmunohistoc

7、hemicalanalysis.［Conclusion］Theincreaseincellularityintheroofofthesubacromialbursaofpatientswith16rotatorcufftearisareactionratherthananinflammatoryprocessandtheinvolvementofthesubacromialbursaisnotlimitedinextent.Thereactionoftheroofofthesubacromialbursaissecondarytotherot

8、atorcufftearratherthanprimarycauseoftherotatorcufftear.Keywords：shoulderjoint；burs