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[骨骼肌活检诊断技术的改进与应用]

[Improvement and application of diagnostic techniques of the skeletal muscle biopsy].

作者信息

Zhang Yan, Han Zhi-hui, Zhong Yan-feng, Wang Sheng-lan, Li Ling-ling, Zheng Dan-feng

机构信息

Department of Pathology, Peking University School of Basic Medical Sciences, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2009 Aug 18;41(4):459-62.

Abstract

OBJECTIVE

To summarize the improvement of various muscle staining techniques and discuss their application in diagnosis of neuromuscular diseases.

METHODS

Three hundred cases of skeletal muscle biopsy samples were examined by histopathological methods. The flash-freezing techniques were used for the preparation of frozen section, which were stained with HE, Gomori trichromic (GMR), glycogen (PAS), and fat acid (oil red O); the enzyme histochemical staining with myosin adenosine triphosphatase (ATPase), and NADH-TR. Those stained methods had been improved. The immunohistochemical staining with dystrophin; and transmission electronic microscopy were used.

RESULTS

Deepfreeze with heteropentane-liquid nitrogen and flash-freezing techniques could avoid artifacts of ice crystal vacuolation. GMR staining mainly showed the degenerative and necrotic lesions of mitochondria and muscle fibers. Oil red O staining showed the increase of lipid in muscle fibers. PAS staining mainly showed glycogen and glycoprotein. Application of frozen sections in muscular tissue was better than that of paraffin sections. NADH-TR staining and ATPase staining could distinguish the two types of muscle fibers, and show the changes of inner structure of muscle fibers and mitochondria enzymes.

CONCLUSION

The distribution and characteristic pathological changes of the two types of muscle fibers can be showed clearly by enzyme and non-enzyme histochemical staining techniques of the skeletal muscle. These methods can compliment with each other. Only after understanding the technical principles can we master and apply these methods.

摘要

目的

总结各种肌肉染色技术的改进情况,并探讨其在神经肌肉疾病诊断中的应用。

方法

采用组织病理学方法对300例骨骼肌活检标本进行检查。采用速冻技术制备冰冻切片,分别进行苏木精-伊红(HE)染色、Gomori三色染色(GMR)、糖原染色(PAS)和脂肪酸染色(油红O);采用肌球蛋白三磷酸腺苷酶(ATPase)和NADH-TR进行酶组织化学染色。对这些染色方法进行了改进。采用抗肌萎缩蛋白免疫组织化学染色以及透射电子显微镜检查。

结果

异戊烷-液氮深度冷冻和速冻技术可避免冰晶空泡伪像。GMR染色主要显示线粒体和肌纤维的变性和坏死病变。油红O染色显示肌纤维内脂质增加。PAS染色主要显示糖原和糖蛋白。冰冻切片在肌肉组织中的应用优于石蜡切片。NADH-TR染色和ATPase染色可区分两种类型的肌纤维,并显示肌纤维内部结构和线粒体酶的变化。

结论

骨骼肌的酶组织化学和非酶组织化学染色技术可清晰显示两种类型肌纤维的分布及特征性病理变化。这些方法可相互补充。只有了解技术原理,才能掌握和应用这些方法。

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