胶原酶在髌骨软骨软化中的作用

２４只新西兰兔，随机分４组。右膝髌骨手术方法造成髌骨倾斜状态为实验侧，左膝实施假手术为对照侧，定期处死动物后进行髌骨软骨面接触压力测量、软骨组织病理观察以及胶原酶免疫组化（ＬＡＢ法）定位。结果：实验膝髌骨倾斜后导致髌内侧面软骨接触压力降低，而髌外侧面软骨接触压力无明显变化；组织病理显示：髌内侧面软骨中层至深层明显变性、软化，髌骨外侧面软骨变性不明显；免疫组化染色显示：髌内侧面软骨中层、深层软骨细胞浆与周围软骨基质胶原酶明显增多，且自软骨下骨长入钙化层或深层的血管内皮细胞以及软骨裂隙边缘处胶原酶强阳性。而髌外侧面软骨胶原酶含量无明显增多。表明：软骨胶原酶增多部位与髌骨软骨软化发生部位及其程度相一致。作者认为，胶原酶对髌骨倾斜导致髌软骨软化过程中软骨基质的破坏起重要作用。

The Effect of Collagenase on Chondromalacia Patellae-an Experimental Study

Twenty-four New Zealand rabbits were randomly divided into 4 groups. The right knees had the patella tilted surgically and were used as the experimental sides. Sham operations were done over the left knees and were used as the controls. The animals were sacrificed at different periods after the operation. The contact pressure of the cartilaginous surface of the patella was measured, histopathological observation and immunohistochemical staining(LAB method) were also performed. The results revealed that, over the experimental side, there was decrease of the contact pressure over the medial aspect of the patella as a result of the artificial tilting of the patella and no similar change was observed over the lateral aspect.Histopathological examination showed that, there was marked degeneration,softening of the middle and deep layer of the cartilaginous surface of the medial side of the patella and not remarkable over the lateral aspect. Immunohistochemical staining showed remarkable increase of collagenase in the chondrocytes cytoplasma over the middle and deep layer of the articular cartilage as well as in the cartilaginous matrix of the medial aspect of the patella. The endothelial cells of the blood vessels ingrown from the subchondrol osseous tissue into the calcified and deeper layers demonstrated a strongly positive reaction of collagenase. There was no remarkable increase of collagenase in the cartilaginous tissue of the lateral side of the patella. The results showed a close correlation of the increase of collagenase in the articular cartilage with the occurrence of condromalacia of the patellae both in location and in extent. The authors concluded that, collagensase exhibited a remarkable destructive effect in the process of development of chondromalacia of the tilted patellae.