强直性脊柱炎髋关节软组织的扫描电镜和X线能谱观察及其临床意义

目的：采用扫描电镜—Ｘ线能谱联机观察强直性脊柱炎（ＡＳ）髋关节囊和滑膜组织的病理变化，用以指导临床治疗。方法：对６例年青ＡＳ病人的髋关节囊和滑膜组织进行固定、干燥、喷金行扫描电镜观察，并用２例老年股骨头坏死髋关节炎的同名组织作对照。对扫描图象中的组织进行Ｘ线能谱扫描以确定是否存在钙颗粒。结果：ＡＳ组的关节囊和滑膜组织中胶原排列紊乱，其间有钙颗粒沉积。而对照组同名组织仅见胶原排列紊乱，Ｘ线能谱显示无钙峰出现。结论：青年ＡＳ病人髋关节囊和滑膜组织均有成骨现象发生，而老年股骨头坏死髋关节炎同名组织无成骨现象。这种软组织病理变化是影响ＡＳ髋关节功能的主要原因。其关节清理术需将关节囊和滑膜全部切除。

The Soft Tissue's Study and its Clinical Meaning for The Hip of Ankylosing Spondylitis by Scanning Electronic Microscope and X-Ray Microanalysis system

Ojective:To ovserve pathological change of articulate bag and synovium of the hip suffering from ankylosing spondylitis (AS) using scanning electronic microscope (S.E.M) and X-ray microanalysis system.And to direct clinical treatment.Method:The specinmen of the bag and synovium from 6 young AS patients were fixed,dried and gold spurted and then observed by scanning electronic microscope.And the same spicimen from 2 old patients suffering from osteoarthritis were used as control.Meanwhile,the pictures of the S.E.M were scanned by X-ray microanalysis syatem to determine whether there were calcic particulates.Result:The collagen of the bag and synovium in AS group arranged disorderly and calcic particulates deposited in gap of the collagen,but in the control grop,there were no calcic particulates were discovered by X-ray scanning,only collage disordered.The results showed the bag and synovium have osteogenesis and collage destroying in young AS patients.This is the main reason for hip stiffness of the AS.It is necessary to clear away all of the bag and synovium of the hip when hip operation for young AS patients.The resean was discussed in the article.