基于尸体解剖的结筋病灶点与筋结点病理组织学差异研究  

Study on Histopathological Difference between Tendon Focus and Tendon Node Based on Autopsy

作　　者：苏玥 董宝强[1] 林星星[1] 王哲[1] SU Yue;DONG Baoqiang;LIN Xingxing;WANG Zhe(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847

出　　处：《辽宁中医杂志》2024年第8期14-17,I0001,共5页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81574050)。

摘　　要：目的结合人体标本的解剖和组织病理学观测,初步揭示不同年龄段的下肢结筋病灶点与筋结点在组织、病理方面的异同,为建立结筋病灶点和筋结点的鉴别标准奠定基础,探讨其可能的病理学机制。方法取12例自愿捐赠的尸体标本作为试验研究对象,其中青、中、老年不同年龄段确定患有膝骨性关节炎(knee osteoarthritis,KOA)的标本各2例,青、中、老年正常尸体标本各2例,对标本进行解剖,对KOA尸体标本的8个膝关节和正常尸体标本的12个膝关节取材并进行病理镜下观察。结果KOA尸体标本中结筋病灶点与正常组中筋结点的病理组织学存在差异,相较于正常尸体标本的筋结点,KOA尸体标本的足三里次、腓骨小头、阳陵次、血海次等结筋病灶点软组织呈现间质血管扩张充血,炎细胞浸润,肌组织纤维间隔增宽,囊壁增厚的趋势,经统计学处理,两者间的差异具有统计学意义(P<0.05),但未达显著水平。结论KOA尸体标本在镜下的组织病理学特点可能与结筋病灶点的结构特性有关,而结筋病灶点和筋结点的病理组织学差异,可能是造成两者在临床鉴别诊断中存在一定困难的主要原因之一,为进一步探索结筋病灶点和筋结点的鉴别诊断标准提供了思路。Objective Combined with the anatomical and histopathological observation of human specimens,this paper preliminarily reveals the histological and pathological similarities and differences between lower limb tendon foci and tendon nodes of different ages,so as to lay a foundation for the establishment of differential criteria between tendon foci and tendon nodes and explore its possible pathological mechanism.Methods Twelve voluntarily donated cadaver specimens were selected as experimental subjects,including 2 cases of knee osteoarthritis(KOA)in young,middle-aged and elderly specimens,and 2 normal cadavers in young,middle-aged and old age.Eight knee joints of KOA cadavers and 12 knee joints of normal cadavers were taken out and observed under pathological microscope.Results The histopathology of tendon nodes in KOA cadavers was different from that in normal cadavers.Compared with the tendon nodes in normal cadavers,the soft tissues in KOA cadavers showed interstitial vascular dilatation and hyperemia,inflammatory cell infiltration,widening of muscle fiber septum and thickening of cyst wall.There was a significant difference between the two groups(P<0.05),but not at a significant level.Conclusion The histopathological features of KOA cadaver specimens under microscope may be related to the structural characteristics of tendon lesions,and the histopathological difference between tendon foci and tendon nodes may be one of the main reasons for their difficulties in clinical differential diagnosis,which provides an idea for further exploration of the differential diagnosis criteria between tendon foci and tendon nodes.

关 键 词：经筋 筋结点 结筋病灶点 膝骨性关节炎 组织病理学 

分 类 号：R224[医药卫生—中医基础理论]