肌纤维母细胞在先天性肌性斜颈中分布的研究

Distribution of Myofibroblast in Congenital Muscular Torticollis

目的研究肌纤维母细胞在先天性肌性斜颈(CMT)中的分布及临床意义。方法利用免疫组化辅以计算机图象定量分析技术。对21例先天性肌性斜颈及10例正常肌肉腱性组织标本α-平滑肌肌动蛋白的表达进行观察和检测。以研究肌纤维母细胞在先天性肌性斜颈(CMT)中的分布。结果-αSMA在对照组中未见明显表达,3例先天性肌性斜颈标本-αSMA染色阴性,18例病变标本中-αSMA染色阳性,病变组与对照组两者差异有非常显著性意义(P<0.001);肌纤维母细胞在肌性斜颈中分布强度与病程有关,6岁以上组分布明显减弱,与6岁以下组(包括6岁)比较差异有显著性意义(P<0.001)。结论肌纤维母细胞是先天性肌性斜颈发病关键病理因素。6岁以上组先天性肌性斜颈中肌纤维母细胞的分布明显减弱,而组织纤维化程度加重,似腱样组织。

Objective To study the expression and distribution of myofibroblast in congenital muscular torticollis （CMT） and discuss its clinical significance and relationship with CMT. Methods Twenty-one specimens from CMT were collected between October in 1994 and October in 2002. The control specimens were collected from normal tendon samples. Expression of alpha smooth muscle actin （（-SMA） in these specimens was detected by immunohistcohemistry and computer image evaluation. Results There was no significant expression of （-SMA in control group except for the positive reaction in the smooth muscle cells of the small vascular walls. Eighteen specimens of CMT were positive for （-SMA. Three specimens of CMT were negative for （-SMA. There was significantly statistical difference of expression of （-SMA between case and control groups （ P 〈 0. 001 ）. In the case group the expression of （-SMA was associated with the course of CMT. Of those aged over 6, the density of （-SMA was obviously lower than those aged less than 6 （including 6） and the difference had statistical significance （P 〈 0.001 ）. Conclusions Myofibroblast is an important factor in the pathogenesis of CMT. The distribution density of myofibroblast in those aged over 6 is going down obviously. And the aligned fibroblasts are surrounded by thick bands of mature collagen fibres, with a tendon-like appearance.