黄韧带骨化的病理组织学研究

目的 :探讨黄韧带骨化的病理变化特点和发生机理。方法 :利用组织病理学和组织化学方法对比研究正常黄韧带和 5例病变黄韧带的病理形态学特点、胶原纤维、网状纤维、弹力纤维以及粘液物质的改变。结果 :根据大体形态特点可将黄韧带骨化分为结节型 (增生性 )骨化、周围型骨化和弥漫型骨化 3种类型。组织学上可见病变早期出现胶原纤维肿胀、融合 ,进一步发生软骨化生 ,最终出现钙化和骨化。在肿胀融合的胶原纤维和软骨化生处可见阿新蓝 (pH 2 5 )阳性的粘液性物质。结论 :黄韧带骨化的大体类型代表着同一病变发展的不同阶段 ;韧带的退行性改变是黄韧带骨化的基本原因 ;胶原纤维的肿胀融合及其粘液样变性是黄韧带骨化的起始病变。

Pathological Study of Ossification of Ligamenta Flava

Objective:To investigate the pathological features and pathogenesis of ossification of the ligamenta flava.Methods:The patho-morphological characteristics of ossification of ligamenta flava and the collagen,reticular fibers,elastic fibers and mucous substance in these ligamenta were comparatively studied in patients(5 cases)and in normal subjects by means of pathological and histochemical techniques.Results:According to the macroscopical pathological features,ossification of ligamenta flava could be recognized as nodular(hyperplasia) type, peripheral type and diffuse type.The earlier lesions of collagen were swollen and fused,later cartilage metaplasia occurred and calcification and ossification finally formed.The mucous substance of Alcian blue(pH2.5) positive staining could be found in swollen and fused collagen,and in cartilage metaplasia.Conclusions:The macroscopical type of the lesion indicates the different stage in development of the ossification of ligamenta flava.The degeneration of the ligament is the essential cause of the ossification.The original-lesion of the ossifications is the swelling and fusion of collagen and its mucoid degeneration.