特发性股骨头缺血坏死动脉病变与发病机制探讨  

Study on pathological change of artery and pathogenesis of idiopathic avascular necrosis of the femeral head

作　　者：王玉峰[1] 常楚[1] 范广宇[1] 原银栋[1] 王星铎[1] 

机构地区：[1]中国医科大学第一临床学院骨科,沈阳110001

出　　处：《中华实验外科杂志》2003年第3期271-272,共2页Chinese Journal of Experimental Surgery

基　　金：辽宁省科学技术基金资助项目 (9680 2 0 0 6)

摘　　要：目的　观察特发性股骨头缺血坏死 (ANFH )股骨头内的病理变化 ,分析小动脉损伤在发病机制中的作用。方法　特发性ANFH患者的股骨头共 34个 ,采用苏木素 伊红 (HE)染色、脂肪、微血栓和弹力纤维染色方法 ,观察股骨头内各部位的坏死和修复及小动脉损伤情况。结果　34个股骨头从头内到支持带中均有动脉损伤 ,小动脉较为普遍 ,内膜破坏、中膜变性和平滑肌细胞变性坏死 ,动脉中还出现管壁上的或骨髓内的变性坏死组织 ,还可见到破碎的小动脉。结论　小动脉损伤是ANFH的重要病理变化 ,在ANFH发病和发展中可能起到至关重要的作用。Objective To observe the pathological changes of idiopathic avascular necrosis of the femeral head (ANFH) and study the role of arteriole injury in the pathogenesis of ANFH.Methods The necrosis and repairment as well as injury of arteriole was observed under a microscope in 34 femoral heads of patients with idiopathic ANFH by means of HE staining,and staining of fat,microthrombus and elastic fiber.Results The injury of arteriole was widely present from head to retinaculu in all of 34 femoral heads.Damage of endometrium,degeneration of media membrane,necrosis of smooth muscle,arteriole with necrosis tissue of dissepiment or of marrow in its canal and ruptured arteriole were observed.Conclusion Injury of arteriole is an important pathological change in the necrosis of the femeral head,and may play an important role in ANFH.

关 键 词：特发性股骨头缺血坏死 动脉病变 发病机制 苏木素—伊红染色 微血栓 弹力纤维 

分 类 号：R681.8[医药卫生—骨科学] R543.5[医药卫生—外科学]