肢体缺血-再灌注后关节软骨病理变化  

Pathological changes of articularc artilage of limbs following ischemi a-reperfusion

作　　者：赵程 王成琪[1] 周继红[2] 孙新君[1] 张伟旭[1] 刘大维[2] 

机构地区：[1]解放军八十九医院创伤骨科研究所,山东省潍坊市260012 [2]第三军医大学大坪医院野战外科研究所,重庆市400042

出　　处：《中华创伤骨科杂志》2004年第12期1377-1379,1387,共4页Chinese Journal of Orthopaedic Trauma

摘　　要：目的了解肢体缺血-再灌注(IR)后关节软骨的病理变化特点,探讨其可能的损伤机制。方法35只成年健康新西兰大白兔随机分为7组,行左侧后肢缺血8h(右侧为对照),于再灌注后1d、3d、1周、2周、4周、8周和12周取膝关节胫骨平台软骨组织,行大体、光学显微镜、透射电镜和扫描电镜观察。结果对照侧肢体关节软骨表面平整,细胞排列整齐,形态正常。肢体缺血-再灌注后1周、2周关节软骨细胞变性、坏死,排列紊乱,数目减少,软骨表面“垄沟”变浅;4周、8周软骨表面粗糙,表层细胞脱落;12周软骨表面溃疡形成,胶原暴露,同时可见新生的软骨细胞。结论肢体缺血-再灌注可导致关节软骨细胞损伤,软骨形态发生变化,与术后慢性关节炎的形成有密切关系。Objective To observe the pathological changes of articular cartilage of limbs foll owing is-chemia-reperfusion(IR)and to explore the injury mechanism o f articular cartilage.Methods In this investigation,35adult New Zealand white rabbits we re randomly divided into 7groups.Af ter 8hours of ischemia,the left hind limbs were reperfused(with the right side as the control).Then at 1day,3days,1weeks,2weeks,4weeks,8weeks and 12weeks,the grouped rabbi ts were killed respectively.The articular cartilages were excised from the knee joints.We observed the pathological changes of articular cartilage under light microscope and electron mic roscope.Results On the control side,the surface of articular cartilage was flat and chond rocytes were well-arranged and in good shape.On the left side,from 1w t o 2w after IR,large amounts of chondr ocytes degenerated and underwent necrosis,with disorder arrangemen t.At 4w and 8w,the articular facets were rough and chondrocytes broke off from the surface.At 12w,although neonate chondrocytes in articular cartila ge were discovered,the articular fa cets were rougher and even some ulcers appeare d on them and the collagen was exposed.Conclusion Following IR of limbs,degeneration and necrosis of chondr ocytes can occur in articular cartilage and the shape of cartilage will ch ange,which can result in the postoperative chro nic arthritis.[

关 键 词：再灌注 肢体缺血 关节软骨细胞 骨病 对照 骨形态 溃疡形成 扫描电镜观察 数目 软骨组织 

分 类 号：R658[医药卫生—外科学]