Department of Biotechnology, Yuanpei University, Taiwan, Republic of China.
Rheumatology (Oxford). 2010 Mar;49(3):548-55. doi: 10.1093/rheumatology/kep359. Epub 2009 Dec 23.
To establish the correlations among the mineral components, progressive calcification process and clinical symptoms of calcific tendonitis.
The morphology of the calcified deposits on the shoulders of 28 patients with calcific tendonitis was determined by high-resolution ultrasonography. The calcified deposit from each patient was aspirated and determined by the Fourier transform infrared and Raman microspectroscopies. The curve-fitting program was applied to estimate the chemical component in the calcified deposits of calcific tendonitis.
The morphology of calcified deposits for 28 patients was classified into four shapes: arc shape (7 patients), fragmented/punctuate shape (4 patients), nodular shape (13 patients) and cystic shape (4 patients). These classified shapes markedly correlated with the pain levels in patients. The infrared spectra of all the calcified deposits for 28 patients were easily classified into three types in the blind study and corresponded to the formative, resting and resorptive phases in the progressive calcification process of calcific tendonitis. With the progressive calcification, the IR wavenumber at 1018 cm(-1) assigned to poorly crystalline, non-stoichiometric apatite for the formative phase was shifted to 1028 cm(-1) for the resting phase and then to 1031 cm(-1) due to matured crystalline stoichiometric apatite for the resorptive phase. The curve-fitted results revealed that calcified deposits in calcific tendonitis were composed of different quantities of A-type and B-type carbonated apatites in the three phases. A significant difference was found in carbonated apatite content among the three phases (P < 0.001).
The different quantities of A-type and B-type carbonated apatites determined by vibrational microspectroscopy in calcified deposits were well correlated with those of the four shapes of morphologic classification, with the three phases in the progressive calcification process and with the clinical symptoms of calcific tendonitis.
建立肌腱钙沉着症的矿物质成分、渐进性钙化过程和临床症状之间的相关性。
通过高分辨率超声检查确定 28 例肌腱钙沉着症患者肩部钙化沉积物的形态。从每位患者抽吸钙化沉积物，并通过傅立叶变换红外和拉曼显微镜光谱进行测定。应用曲线拟合程序来估计肌腱钙沉着症钙化沉积物中的化学成分。
28 例患者的钙化沉积物形态分为 4 种类型：弧形（7 例）、碎裂/点状（4 例）、结节状（13 例）和囊性（4 例）。这些分类形态与患者的疼痛程度明显相关。在盲法研究中，28 例患者的所有钙化沉积物的红外光谱很容易分为 3 种类型，与肌腱钙沉着症渐进性钙化过程中的形成期、静止期和吸收期相对应。随着渐进性钙化，1018cm(-1)处分配给形成期非晶态、非化学计量磷灰石的 IR 波数向休息期的 1028cm(-1)移动，然后由于成熟的结晶化学计量磷灰石向吸收期的 1031cm(-1)移动。曲线拟合结果表明，肌腱钙沉着症的钙化沉积物在 3 个阶段由不同数量的 A 型和 B 型碳酸磷灰石组成。3 个阶段之间的碳酸磷灰石含量存在显著差异（P < 0.001）。
通过振动显微镜在钙化沉积物中测定的不同数量的 A 型和 B 型碳酸磷灰石与形态分类的 4 种类型、渐进性钙化过程的 3 个阶段以及肌腱钙沉着症的临床症状密切相关。
