松动人工髋关节界膜的免疫组化研究  

Immunohistochemistry research of interface membrane around loosening hip prosthesis

作　　者：卢伟杰[1] 廖威明[2] 余楠生[1] 罗新乐[1] 白波[1] 林志雄[1] 顾莹莹[3] 刘慕嫦[3] 杨通[3] 

机构地区：[1]广州医学院第一附属医院骨科,510120 [2]中山大学第一附属医院骨科 [3]广州医学院第一附属医院病理科,510120

出　　处：《中国医师进修杂志（外科版）》2006年第2期34-36,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 对髋翻修假体周围界膜进行免疫组化研究，探讨假体松动机理。方法 选取1995年2月～2003年12月因人工髋关节松动而行翻修术的29例患者，对人工全髋翻修假体周围界膜进行免疫组化检查，部分界膜行透射和扫描电镜检查。结果 （1）透射电镜检查见细胞线粒体肿胀。部分细胞胞浆见类脂质。扫描电镜检查：异物颗粒。（2）免疫组化结果：29例患者中共有22例翻修患者界膜内巨噬细胞、成纤维细胞、异物巨细胞IL-1β免疫组化阳性；29例翻修患者界膜内巨噬细胞、成纤维细胞、异物巨细胞均出现IL-6免疫组化阳性；TNF-α免疫组化未做出阳性结果。结论 （1）假体磨损产生磨损颗粒是引起生物学反应的重要因素。（2）界膜含有细胞因子IL-1β、IL-6，可能在假体周围骨溶解和假体松动中起重要作用。Objective Collecting the loosening periprosthetic interface- membrane, to discuss the mechanism of hip arthroplasty loosening. Methods The periprosthetic interface tissues of 29 hip arthroplasty revision cases from February 1995 to December 2003 were collected. The retrieved periprosthetic interface tissues were detected by immunohistochemistry. Some of them were studied by electronic micrscope. Results （1）Transmission electronic microscope examination： the mitochondria swell. There were some substantia like lipid in the plasm of macrophages. Wear particles could be seen under scaning electronic microscope. （2） Immunohistochemistry： there were 22 IL - 1β positive cases in cells of interface membrane. There were 29 IL- 6 positive cases in cells of interface membrane. There were no positive results in TNF- α test. Conclusion （1）The wear particles of arthroplasty are important factors which cause biological reaction. （2）The interface membranes contain cytokine IL - 1β and IL- 6, which may play an important role in periprosthetic osteolysis and arthroplasty loosening.

关 键 词：髋 假体松动 界膜 免疫组化 

分 类 号：R687.4[医药卫生—骨科学] R595.6[医药卫生—外科学]