中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (37): 7008-7011.doi: 10.3969/j.issn.1673-8225.2010.37.040

• 组织构建临床实践 clinical practice in tissue construction • 上一篇    下一篇

特发性脊柱侧凸患者髓核结构特点及相关病因学

陆  明1，2，V.Ya. Fischenko○2，V.A. Vleschenko○2，Y. V. Fischenko○2   

  1. 1解放军306医院骨科，北京市100101；2乌克兰医学科学院创伤矫形研究院脊柱外科，乌克兰基辅  252054
  • 出版日期:2010-09-10 发布日期:2010-09-10
  • 作者简介:陆明☆，女，1969 年生，吉林省长春市人，汉族，1997 年乌克兰医学科学院创伤矫形研究院毕业，医学博士，副主任医师，副教授，主要从事脊柱外科及生物力学方面的研究。 luming8788@yahoo.com.cn

Structural characteristics of nucleus pulposus and related etiology in patients with idiopathic scoliosis

Lu Ming 1,2, V. Ya. Fischenko2, V.A. Vleschenko2, Y. V. Fischenko2   

  1. 1 Department of Orthopaedics, the 306 Hospital of Chinese PLA, Beijing  100101, China; 2 Department of Spine Surgery, Orthopaedic Trauma Institute, Ukraine Academy of Medical Sciences, Kiev  252054, Ukraine
  • Online:2010-09-10 Published:2010-09-10
  • About author:Lu Ming☆, Doctor, Associate chief physician, Associate professor, Department of Orthopaedics, the 306 Hospital of Chinese PLA, Beijing 100101, China; Department of Spine Surgery, Orthopaedic Trauma Institute, Ukraine Academy of Medical Sciences, Kiev 252054, Ukraine luming8788@yahoo.com.cn

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305

被引次数

7

摘要：

背景：在脊柱侧凸疾病发展过程中，支撑-运动系统(骨骼-肌肉系统)的各个组成部分都发生变化。有些症状具有原发病的特点，另外一些表现为由脊柱侧凸继发的合并症。
目的：探讨脊柱侧凸患者髓核组织结构病理变化特点与病因学的相互关系。
方法：选择年龄在13~15岁的KingⅡ，Ⅲ型脊柱侧凸患者22例，男3例，女19例，共214个主弯和代偿弯髓核标本。经常规处理后，在明胶管中进行环氧化聚合。再将获得的组织明胶块经超声切片机切片，制成1750份连续超薄组织切片，电镜下髓核组织标本的变化特点和组织化学性能的改变。
结果与结论：电镜下，在透明软骨板和髓核交界处显示不大的纤维组织条带层。并且以kingⅢ型脊柱侧弯患者最为明显。在髓核细胞中存在异染色的非黏多糖酸类物质和弹力蛋白，但不能证实其为，透明质酸(细菌和睾丸透明质酸)破坏的结果。电组织化学法观察发现，代偿弯顶点髓核中的软骨细胞具有统一性：少见含有均匀磷酸酶酸的溶体。这些细胞中的溶体清晰，缺少内部结构，被确定为原生性，不参与细胞的自我消耗性溶解和其他类型的组织消化溶解。而各种类型的由外生性细胞增多带来的大量溶体酶，并导致细胞的自体消耗，内部结构的溶解，但这种破坏过程在代偿弯的髓核组织中没有被发现。因此，说明在髓核组织的病理重建过程中溶体酶是以造成自体消耗的形式加入的，在酶的作用下髓核组织超微结构功能的破坏，引起畸形的发展。

关键词: 脊柱侧凸, 髓核组织, 自耗性溶体酶, 组织学观察, 骨组织工程

Abstract:

BACKGROUND: Support-motion system (skeleton-muscular system) alters during idiopathic scoliosis advancement. Some symptoms present with idiopathic scoliosis, others exhibit secondary scoliosis.
OBJECTIVE: To explore the relationship between pathological change features and etiology of the nucleus scoliosis in patients with scoliosis.
METHODS: Totaly 214 main and compensatory curve samples of nucleus pulposus were harvested from 22 cases with King Ⅱ, Ⅲ types scoliosis, aged 13-15 years, including 3 males and 19 females. After conventional treatment, samples were performed epoxy-polymerization in the isinglass tube. Gelatin blocks were prepared 1 750 copies of a continuous ultra-thin tissue sections. The change features and histochemistrical alteration of nucleus pulpous were observed under an electron microscope.
RESULTS AND CONCLUSION: Under an electron microscope, few fibrous tissue bands could be seen at the junction of plate and nucleus of hyaline cartilage, especially obviously in patients with king Ⅲ type of scoliosis. There were metachromasia non-substances acid mucopolysaccharide and elastin in in the nucleus pulposus cells, but it could not be confirmed resulting from hyaluronic acid (testis hyaluronic acid and bacteria) damage. Electric-chemistry observation showed that, compensatory bend vertex in the cartilage cells presented with nucleus unity, and few lysosomal solution containing lysosomal acid phosphatase could be seen. Dissolved body in these cells were clearly, but lack of internal structures. They were identified as idiopathic structural scoliosis, which not involved in cell self-consuming of dissolution or dissolution of other types of organizations. The various types of cells increased by exogenous brought a large number of lysosomal enzymes, and led to cell autologous consumption, the internal structure of the dissolution, but this destruction process in compensatory bend in the nucleus pulposus has not been found in. Accordingly, in the pathological process of reconstructing nucleus pulposus, lysosomal enzyme paticipates with the form of self-consuming, the ultrastructure of nucleus pulposus was damaged under condition of enzymatic action, thus, result in malformation.

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