强直性脊柱炎髋关节的组织病理学和超微结构观察

Histopathological and Ultrastructural Observation of the Hip in Ankylosing Spondylitis

目的：了解强直性脊柱炎（ＡＳ）髋关节病变时关节组成成分的组织病理学及超微结构。方法：采用８例ＡＳ髋关节手术取下的关节囊、滑膜、软骨和骨。分别作切片在光镜、透射电镜和扫描电镜———Ｘ线能谱仪联机观察组织病理学和超微结构。结果：发现关节囊纤维增生、变性；扫描电镜显示为胶原纤维排列紊乱，其中有钙颗粒沉积。透射电镜显示多量成纤维细胞处于成熟阶段。滑膜以毛细血管增生及炎细胞浸润，成纤维细胞增生为特征。软骨细胞坏死和纤维修复。股骨头内的骨小梁紊乱，纤维组织增生、透射电镜下可见活跃的成纤维细胞和成骨细胞。结论：强直性脊柱炎的髋关节的关节囊、股骨头、滑膜中的上述病变，均可造成髋关节的功能障碍和破坏。

Objective:To observe the histopathological and ultrastructural changes of the hip in ankylosing spondylitis(AS) and inquire into the reasons of AS hip.Methods:8 speciments of capsule,synovium,cartilage and bone were collected from operated AS patients.The sections were observed separately by microscope,electron microscope(E.M) and scanning electronic microscope(S.E.M)with X-ray microanalysis system.Results:Fibroplastic proliferation and fibrosis in the microscope were found.It was showed that collagenous fibers arranged disorderly and calcic particulates deposited testing by S.E.M and X-ray scanning,and many fibroblasts in mature phase at the pictures of E.M.for the capsules.The specific changes of AS synovium were capillary proliferation,inflammatory cells infiltration,disturbanced collage with calcic particulates and necrosis cells.The cartilage cells were necrosis and fibrosis.In femoral head,it was found that bone trabeculas disturbed ause hip disfunction and dystrophy.