血管活性肠肽在关节炎关节软骨中的表达及临床意义  

The expression and significance of vasoactive intestinal polypeptide(VIP) in the cartilage of OA

作　　者：陈霞光[1] 雷光华[2] 钱锐[1] 肖诗梁[1] 蔡幸健[1] 刘振逾[1] 

机构地区：[1]赣州市人民医院骨二科,江西赣州341000 [2]中南大学湘雅医院骨科,湖南长沙410008

出　　处：《赣南医学院学报》2011年第1期26-28,F0003,共4页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨血管活性肠肽(VIP)在不同退变程度骨关节炎软骨中的表达,及其与骨关节炎发病以及软骨退变程度的关系,为临床防治提供思路。方法:选取中南大学湘雅医院骨科进行关节置换的骨关节炎患者关节软骨标本26个,另选取因外伤行截肢的膝关节软骨或股骨颈暴力骨折的股骨头正常关节软骨标本10个为对照组,根据大体观察凿取正常和OA不同退变严重程度软骨块50个,再根据关节软骨改良Mankin病理评分法进行分组,采用免疫组织化学染色检测软骨组织中VIP的表达和分布,对阳性染色(棕黄色)的平均光密度进行半定量分析。结果:①各组关节软骨中可见到VIP阳性神经纤维,各组间VIP阳性神经纤维数无显著差异。②正常组关节软骨VIP平均光密度为(0.2603±0.0396),骨关节炎组关节软骨VIP平均光密度为(0.1937±0.0494),OA组与对照组比较VIP含量下降,差异有显著性(P<0.05)。③VIP含量与软骨改良Mankin病理评分呈负相关关系。结论:①首次发现正常关节软骨和骨关节炎软骨中有VIP阳性神经纤维分布。②VIP低表达可能是关节软骨退变、骨关节炎发病的机理之一。③VIP低表达与关节软骨退变程度、骨关节炎病程进展相关。Objective：The expression of vasoactive intestinal peptide（VIP） in the different impaired cartilage of osteoarthritis of human was studied to approach the correlation and possible involvement of VIP in pathogenesis and progression of osteoarthritis as to give a theoretical evidence for prevention and treatment for OA.Methods：Human cartilages were obtained at arthroplasty from 26 patients with OA.Corresponding articular cartilages were obtained at arthroplasty or amputation for trauma,tumour or infection from 10 patients with no history of arthritis.Then collect 50 cartilage specimens from OA and normal joint,all the specimens were fixed,decalcified,embedded in paraffin and cut into slices.Each slices sample was stained with HE and Safranin O,on the basis of improved Mankin pathological score to divide them into four groups.Meanwhile,the slices were treated by immunohistochemical reaction of VIP and dealed with micrograph analyze instrument（MIAS system）.Each slice was randomly mensured 4 high fields of eyeshot,and made semi-quantitative analysis of average optical density（AOD）.Results：① VIP positive nerve fibers exist in normal and OA human cartilage in all layer,There are no significant differences between each group.②The AOD of VIP in the normal group A is（0.2603±0.0396）,OA group（0.1937±0.0494）.There are significant differences between osteoarthritis group and nomal group（P0.05）.③According to Spearman rank correlation test,the AOD of VIP have direct correlation with the improved Mankin pathological score（r=-0.896,P0.05）.Conclusion： ①The first time discovered that VIP positive nerve fibers exist in normal human cartilage.②VIP low expression is one of important pathogenesis in OA.③With the expression of VIP decreased,the cartalege of OA impaired increases by degrees.

关 键 词：骨关节炎 血管活性肠肽 

分 类 号：R681.3[医药卫生—骨科学]