青少年特发性脊柱侧凸患者下关节突软骨的组织形态学研究

Histomorphological study of inferior facet process cartilage between convex side and concave side in adolescent idiopathic scoliosis

目的:观察青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者上、下端椎及顶椎凸、凹侧下关节突软骨组织学分级和软骨细胞的增殖与凋亡,探讨其软骨内成骨性生长在侧凸进展中的作用。方法:16例AIS患者,平均年龄13.5岁,取上、下端椎和顶椎凸、凹侧下关节突进行组织学观察及免疫组织化学测定其软骨细胞的增殖指数(proliferation cell nuclear antigen,PCNA)和凋亡指数(Poly ADP-ribose polymerase,PARP)。采用PCNA/PARP比值及组织学分级作为软骨内成骨活跃程度的指标,并对其进行比较。结果:AIS患者上、下端椎和顶椎凸、凹侧下关节突软骨组织学分级、软骨细胞的增殖指数(PCNA)、凋亡指数(PARP)和PCNA/PARP比值的比较均没有统计学差异(P>0.05)。结论:AIS患者上、下端椎和顶椎凸、凹侧下关节突软骨内成骨活跃程度没有差异,关节突软骨内成骨性生长发育可能对脊柱侧凸进展没有明显的作用。

Objective：To compare the difference of histological grades of cartilage and proliferation and apoptosis of chondrocytes in inferior facet processes between convex side and concave side in AIS and identify the effect of endochondral bone formation on the progression of scoliosis.Method：16 patients with Risser 0-3 were included in this study.The mean age was 13.5 years old. The histological grades were defined under the light microscope.The proliferation index（proliferation cell nuclear antigen,PCNA-index）,apoptosis index （Poly ADP-ribose polymerase,PARP-index）,PCNA/PARP ratio of chondrocytes and histological grades of cartilage in the inferior facet processes by immunohistochemistry were compared between the convex side and the concave side in AIS.Result：No significant difference was found in proliferation index,apoptosis index and PCNA/PARP ratio of chondrocytes and histological grades of cartilage in the inferior facet processes between convex and concave side in AIS（P〉0.05）.Conclusion：No difference with respect to endochondral bone formation activity was found in the inferior facet processes between convex and concave side in AIS.The growth of facet processes may not play a role in the progression of scoliosis.