特发性脊柱侧凸患者椎旁肌中胶原的表达及意义

The expression and significance of collagen in the paraspinal muscles in idiopathic scoliosis

目的:通过比较特发性脊柱侧凸(idiopathic scoliosis,IS)、先天性脊柱侧凸(congenital scoliosis,CS)顶椎凹凸侧椎旁肌和无脊柱侧凸患者椎旁肌的组织形态学改变及胶原蛋白表达的变化,探讨椎旁肌在IS发展中的作用机制。方法:分别取IS患者(A组)、CS患者(B组)顶椎凹凸两侧及无脊柱侧凸患者(对照组,C组)的椎旁肌,光镜和电镜下观察其组织学形态学改变;应用Masson三色染色法显示胶原蛋白的表达,图像分析系统测量各组胶原的阳性表达面积百分比;对各组结果采用SPSS13.0软件进行统计学处理。应用免疫组织化学方法对Ⅰ型和Ⅲ型胶原染色,观察其在各组的表达情况。结果:光镜和电镜下均显示A、B组凹侧椎旁肌形态明显异常,胶原表达增强、分布紊乱;A、B组凸侧椎旁肌及C组未见明显异常。A、B组凹侧椎旁肌中阳性胶原面积的百分比分别为0.255±0.036和0.253±0.023,明显高于凸侧(A、B组分别为0.057±0.006和0.055±0.002)及C组(0.056±0.004),差异有显著性(P<0.05)。免疫组织化学染色示A、B两组凹侧椎旁肌中Ⅰ型、Ⅲ型胶原表达无明显差异,而在凸侧椎旁肌中以Ⅰ型胶原阳性者为主。结论:IS患者凹侧椎旁肌形态明显异常,胶原表达增强且分布紊乱,其变化可能为IS的继发性改变。

Objective：To investigate the expression morphylogical status of collagen in the paraspinal muscles at the apex vertebrae of the curve in idiopathic scoliosis（IS） and congenital scoliosis（CS） and their role in the pathogenics of IS.Method：Specimens of muscle were harvested from the paraspinal muscle at the apex of the curve in the cases with IS group（group A）,CS（group B） and the control group（group C）.The pathological changes of mucslces were examined under light-microscope and electron-microscope.The cross-sections of muscles were stained with Masson Trichrome to show the expression of collagen and the percent of positive axea（PA） was measured using image analysis system and analyzed statistically.Anti-collagen Ⅰ and anti-collagen Ⅲ antibodies were used to stain type Ⅰ and Ⅲ collagen.Result：Pathological change of the paraspinal muscles on the concave side in group A and B appeared more severe,while relatively nomal on the convex side in group A and B and in group C.Collagen expression level increased and its distribution was abnoemal. The percent of PA in concave side of paraspinal muscle in group A and B （0.255±0.036 and 0.253±0.023 respectively） was larger than that in convex side of paraspinal muscle in group A and B （0.057±0.006 and 0.055±0.002 respectively） and group C （0.056±0.004）（P〈0.05）.There were no difference with respect to the expression of type Ⅰ and Ⅲ collagen in paraspinal muscles in concave side of paraspinal muscle between group A and B,while type Ⅰ collagen was evidenced more in the concave side of paraspinal muscles.Conclusion：The expression of collagen in the concave side of parapinal muscle in IS increases,which may be secondary to IS.