成人髁突软骨潮标的组织学及超微结构研究

目的 研究成人髁突软骨潮标的组织学形态、超微结构及其意义。方法 50例成人髁突常规石蜡制片，HE染色，部分标本行Van-Gieson及组织化学染色，光镜观察。并对3例潮标作透射电镜、5例作扫描电镜观察。结果 髁突软骨潮标区碱性磷酸酶及钙质大量存在、蛋白多糖缺乏；膜被基质小泡、羟磷灰石结晶、脂质小结样物质丰富，且多见于关节负重区。未钙化软骨内的胶原纤维斜行通过潮标后与钙化软骨内的纤维相连续，水平纤维束环绕整个潮标区域，负重区较宽，并与斜行纤维交织成网状。经木瓜蛋白酶消化，潮标表面高低不平，可见许多被钙质包绕的软骨细胞陷窝。结论 髁突软骨潮标区有生理性钙化发生，其活性在负重区高于非负重区；斜行纤维与水平纤维交织成网，与关节受力有关。

A histological and ultrastructural study of the tidemark in human condylar cartilage

Objective To study the histology and ultrastructure of the tidemark in the adult condylar cartilage and their significance. Methods After embedded in paraffin,50 adult condyles were stained with HE, partly with Van Gieson and histochemical methods, then observed by light microscope. 3 cases of the tidemark region were observed by transmission electron microscope,another 5 cases were studied by scanning electron microscope. Results In the tidemark region, there had shown the presence of the AKP and calcium, absence of the proteoglycan, abundance of the membrane bound matrix vesicles, crystals of hydroxyapatite and lipid nodule like substances, which were often observed in the load bearing areas. The collagen fibrils of the noncalcified cartilage crossed the tidemark gradiently and were continuous with those of the calcified catilage; a band of horizontal fibrils surrounded the whole tidemark region, which was wider in the load bearing areas than that in the nonload bearing areas and which interweaved with the gradient fibrils so as to form a net. Digested with papain, the surface of the tidemark was highly undulating, and a lot of chondrocyte lacunae were seen on the surface, which were surrounded by calcified tissues. Conclusions In the region of the tidemark, physiological calcification takes place and is more active in the load bearing areas; gradient and horizontal fibrils interweave with each other, which is correlated with the force on the articulation.