前列腺素E2在肩袖损伤中作用的研究

目的探讨前列腺素E2（prostaglandinE2，PGE2）在肩袖损伤中的作用。方法标本分为5组：撕裂组8例，钙化性冈上肌腱炎组11例，新鲜尸体组6例，阳性对照组和阴性对照组各10例。其中前3组为冈上肌腱标本，阳性对照组和阴性对照组为重度骨性关节炎滑膜标本。同时在阴性对照组中将一抗替换为PBS缓冲液。所有标本均采用微波热修复抗原，一抗使用ABCAM公司兔抗人PGE2单克隆抗体，1：100稀释后使用于免疫组化法染色。人工定位所有细胞集中区域，以400倍照相显微镜采集图像，并在图像编号后采用计算机随机数生成软件随机抽取8个编号所对应的高倍视野（×400）图像，用IPP6．0图像处理软件，以除去细胞核外的所有区域为感兴趣区，测量面积和光密度，并计算平均光密度（meanopticaldensity，MOD）以评价PGE，表达量，并对结果进行t检验，其中a=0．05。结果阴性对照组组织细胞质和细胞外基质均呈阴性染色；阳性对照组组织细胞质呈强阳性染色，基质呈弱阳性染色；新鲜尸体组细胞质和基质均呈阴性染色；钙化性冈上肌腱炎组细胞质及基质均呈弱阳性染色；撕裂组细胞质呈强阳性染色，基质呈弱阳性染色。肩袖撕裂组平均光密度为0．3158±0．0204，钙化性冈上肌腱炎组平均光密度为0．0907±0．0160，新鲜尸体组平均光密度为0．0404±0．0096。撕裂组与新鲜尸体组比较，PGE2表达明显增高，差异有统计学意义（P〈0．001）。钙化性冈上肌腱炎组与新鲜尸体组比较，PGE：表达轻度增高，差异有统计学意义（P〈0．001）。撕裂组较钙化性冈上肌腱炎组，PGE2显著增高，差异有统计学意义（P〈0．001）。结论肩袖损伤患者冈上肌腱中PGE2呈高表达，提示肩袖损伤与PGE2高表达相关。

A preliminary study of effects of prostaglandin E2 on rotator cuff injuries

Objective To investigate the effects of prostaglandin E2 （ PGE2 ） on rotator cuff injuries. Methods The samples were divided into 5 groups, including tear group （ n=8 ）, calcified supraspinatus tendonitis group （ n=ll ）, fresh cadaver group （ n=6 ）, positive control group （ n=lO ） and negative control group （ n=10 ）. The samples of the former 3 groups were tissues of supraspinatus tendons. The samples of the positive control group and negative control group were synoviums got from patients with serious osteoarthritis, and in the negative control group phosphate buffered saline （ PBS ） solution was used instead of primary antibodies. Before being stained with immunohistochemistry, all samples were detected by using microwave antigen retrieval. The primary antibodies were rabbit anti-human PGE2 monoclonal antibodies from ABCAM Company, which were diluted for 100 times. All the areas of cell aggregation were manually located, and the images were collected with a photomicroscope （ ×400 ）. After the images were numbered, the computer random number generation software was utilized to select 8 numbered high power fields （ ×400 ） randomly. When all the areas except for the cell nucleus were taken as the regions of interest, the area and absorbance were measured by the Image-Pro Plus 6.0 （ IPP6.0 ） image processing software, and the mean optical density （ MOD ） was calculated. After that the expressions of PGE2 were evaluated, and the results were studied by t-test （ α=0.05 ）. Results The cytoplasm and extracellular matrix in the negative control group were both stained negatively, which were the same in the fresh cadaver group. In the positive control group, the cytoplasm and matrix showed strongly and weakly positive staining respectively, which were the same in the tear group. The cytoplasm and matrix in the calcified supraspinatus tendonitis group both showed weakly positive staining. The MOD in the tear group was 0.3158±0.0204, which was 0.0907±0.0160 in the calcified supraspinatus tendonitis group and 0.0404±0.0096 in the fresh cadaver group. The expressions of PGE2 in the tear group were significantly higher than that in the freshcadaver group, and the differences were statistically significant （ P〈0.001 ）. The expressions of PGE2 in the calcified supraspinatus tendonitis group were slightly higher than that in the fresh cadaver group, and the differences were statistically significant （ P〈0.001 ）. The expressions of PGE2 in the tear group were significantly higher than that in the calcified supraspinatus tendonitis group, and the differences were statistically significant （ P〈0.001 ）. Conclusions PGE2 is highly expressed in the supraspinatus tendons of patients with rotator cuff injuries, which means the rotator cuff injuries are connected with the high expressions of PGE2 to some extent.