强直性脊柱炎竖脊肌免疫组化分析

目的观察CD4、CD8、CD20、CD68及MHC-Ⅰ在强直性脊柱炎（AS）竖脊肌中的表达,了解AS竖脊肌中是否存在炎性改变。方法收集AS（AS组）、多发性肌炎（PM,PM组）和腰椎间盘突出症（LIDP,LIDP组）患者的肌肉标本各10例。冰冻切片后,对各组切片用ABC法进行CD4、CD8、CD20、CD68及MHC-Ⅰ等抗体的免疫组织化学染色,以PM组作为阳性对照,LIDP组作为阴性对照。并对各组中CD4、CD8、CD68和MHC-Ⅰ的IOD值进行比较。结果 3组中CD20均为阴性。AS组CD4、CD8、MHC-Ⅰ的IOD值均高于LIDP组,差异均有统计学意义（均P〈0.05）;AS组CD8、MHC-Ⅰ的IOD与PM组比较差异均无统计学意义（均P〉0.05）,PM组CD4、CD68的IOD明显高于AS组（均P〈0.05）。结论 AS患者竖脊肌中存在与单核细胞相关的炎性细胞浸润,且在炎性细胞周围伴随局灶性肌纤维坏死,其坏死与炎性浸润有密切关系。

Immunohistologic Analysis of Erector Spinae in Patients with Ankylosing Spondylitis

Objective To observe the expression of CD4,CD8,CD20,CD68 and MHC-Ⅰ in erector spinae in patients with ankylosing spondylitis（AS）,and to investigate inflammatory change in erector spinae.Methods The expression of D4,CD8,CD20,CD68 and MHC-Ⅰ was detected by immunohistochemical staining of frozen tissue sections（ABC method） in 10 muscle specimens from patients with AS,10 muscle specimens from patients with polymyositis（PM） and 10 muscle specimens from patients with lumbar intervertebral disc protrusion（LIDP）.PM group was used as positive control and LIDP group as negative control.IOD values of CD4,CD8,CD68,MHC-Ⅰ expression were compared among the three groups.Results Positive expression of CD20 was not found in all specimens.IOD values of CD4,CD8 and MHC-Ⅰ expression were significantly different between AS group and LIDP group（P0.05）.There were no obvious differences in IOD values of CD8 and MHC-Ⅰ expression between AS group and PM group（P0.05）,but IOD values of CD4 and CD68 in PM group were significantly greater than those in AS group（P0.05）.Conclusion Inflammatory mononuclear cell infiltration and focal muscle fiber necrosis are present in erector spinae muscles of patients with AS,and there is a close relationship between muscle fiber necrosis and inflammatory infiltration.