青少年特发性脊柱侧凸脊柱前后柱骨骺软骨细胞的增殖和凋亡

目的　通过对青少年特发性脊柱侧凸 (adolescentidiopathicscoliosis ,简称AIS)脊柱前后柱次发性生长骨骺的增殖和凋亡研究 ,发现AIS患者青春期脊柱前后柱生长活跃度的差异。方法AIS组患者 17例 (男性 4例 ,女性 13例 ) ,平均年龄 13 6岁 (10～ 17岁 ) ,均有累及胸段的脊柱侧弯 ,术前Cobb角 6 5°～ 115°,平均 89 3° ,Risser分级 0～ 3。取材部位为顶椎区终板软骨和棘突次发性生长骨骺。HE染色 ,光镜下观察生长板软骨细胞层结构变化。免疫组化增殖采用细胞增殖核抗原 (PCNA)指数 ,凋亡采用原位末端标记法 (TUNEL)指数 ,采用PCAN/TUNEL作为生长活跃度的指标。结果　AIS前柱 (终板软骨 )细胞增殖活跃 ,增生骨巢密集且厚度较大 ;后柱软骨增生程度一般 ,增殖层内骨巢散在分布呈团状 ,骨巢厚度较前柱低。前后柱骨骺软骨静止区、增殖区以及肥大区均有PCNA和TUNEL阳性细胞 ,PCNA指数前后柱大于后柱 (P <0 0 5 ) ,PCNA/TUNEL指数前柱大于后柱 (P <0 0 1)。静止层未见显著差异 (P >0 0 5 )。结论　特发性脊柱侧凸患者青春期脊柱前后柱软骨细胞生长活性存在明显差异

Cell viability between anterior and posterior spinal growth plate in adolescent idiopathic scoliosis

Objective To compare the cell viability of chondrocytes between the anterior and the posterior spinal growth plates in adolescent idiopathic scoliosis (AIS) by proliferation and apoptosis labelling. Methods Seventeen AIS patients (4 male and 13 female, mean age 13.6 years old, ranged from 10 to 17 years old) were recruited in this study. Growth plates were harvested during anterior and posterior surgery. PCNA (proliferating cell nuclear antigen) and TUNEL (terminal deoxynucleotide transferase-mediated nick end labeling) were used for proliferation and apoptosis labeling on chondrocytes respectively. Results In AIS, the distribution of the proliferating nests were denser and more parallel in anterior column than those in posterior under microscope observation. In the proliferative and hypertrophic zone the PCNA index and PCNA/TUNEL ratio were higher in the anterior column than those in the posterior column (P<0.05 and P<0.01 respectively). While in resting zone the differences were not so significant. Conclusion In adolescent idiopathic scoliosis the growth viability of chondrocytes is more vigorous in anterior spinal column than in the posterior column.