Konttinen Y T, Santavirta S, Paavolainen P, Antti-Poika I, Tiainen T, Nordström D, Hukkanen M
Department of Anatomy, University of Helsinki, Finland.
Arch Orthop Trauma Surg. 1992;111(6):341-4. doi: 10.1007/BF00420063.
Coracoacromial ligament and periligamentous fatty and loose connective tissue obtained during Neer's acromioplasty in patients with chronic painful rotator cuff tendinitis/impingement syndrome was studied for possible signs of inflammatory involvement and for the presence of neuropeptide-containing nerves, using routine histology and immunoperoxidase staining. No accumulations of inflammatory cells were found in the tissues studied. The dense ligamentous tissue proper was practically aneural, as was seen in staining for the generalized neuronal markers protein gene product 9.5 and synaptophysin. In contrast, the periligamentous fatty and loose connective tissue was innervated. Almost all nerves in such tissue contained C-flanking peptide of neuropeptide Y, whereas substance P, calcitonin gene-related peptide, and vasoactive intestinal peptide-containing nerves were not found at all or were extremely rare. This suggests that the coracoacromial ligament is not a target of irritative inflammation. In the periligamentary sheath, nerves containing markers for the C-type nociceptive pain fibers were practically absent and all local nerves were postganglionic sympathetic vaso-regulatory nerves.
对慢性疼痛性肩袖肌腱炎/撞击综合征患者行Neer肩峰成形术时获取的喙肩韧带及韧带周围脂肪和疏松结缔组织进行研究，采用常规组织学和免疫过氧化物酶染色，观察有无炎症累及迹象及含神经肽神经的存在情况。在所研究的组织中未发现炎症细胞聚集。在对通用神经元标志物蛋白基因产物9.5和突触素进行染色时发现，致密的韧带组织本身实际上无神经分布。相比之下，韧带周围脂肪和疏松结缔组织有神经支配。该组织中几乎所有神经都含有神经肽Y的C端侧翼肽，而含P物质、降钙素基因相关肽和血管活性肠肽的神经根本未发现或极其罕见。这表明喙肩韧带不是刺激性炎症的靶点。在韧带周围鞘中，几乎不存在含C型伤害性疼痛纤维标志物的神经，所有局部神经均为节后交感血管调节神经。
