Lehto M, Jozsa L, Kvist M, Järvinen M, Balint B J, Reffy A
Department of Surgery, University Central Hospital, Tampere, Finland.
Ann Chir Gynaecol. 1990;79(2):72-7.
The purpose of the present study was to examine the role and distribution of fibronectin--a major connective tissue protein--in normal and ruptured Achilles tendon and its paratenon using peroxidase antiperoxidase (PAP) method and conventional histology. Samples were taken intraoperatively 6 to 48 hours after rupture from 30 patients, and 4 male cadavers served as controls. In controls fibronectin could not be detected in the tendinous connective tissue or in the areolar tissue of the paratenon. In the ruptured tendons fibronectin was detected around the tenocytes and in the collagen fibres in the necrotic and mucinous degenerated areas, but also in the macroscopically healthy areas of the tendon. In the oedematous paratenon vascular walls were rich in fibronectin and fat cells were outlined by fibronectin. Areas of homogenous deposition of fibronectin were also frequently seen in the paratenon. A vast amount of fibronectin was observed also at the site of rupture. The present results indicate that there are striking changes in the composition of connective tissue in degenerated tendon and paratenon. These changes seem to have increased susceptibility of the tendon to rupture.
本研究的目的是采用过氧化物酶抗过氧化物酶（PAP）法和传统组织学方法，研究纤连蛋白（一种主要的结缔组织蛋白）在正常和断裂的跟腱及其腱旁组织中的作用和分布。从30例患者中在破裂后6至48小时术中取样，4具男性尸体作为对照。在对照中，在腱性结缔组织或腱旁组织的疏松结缔组织中未检测到纤连蛋白。在断裂的肌腱中，在坏死和黏液样变性区域的腱细胞周围和胶原纤维中检测到纤连蛋白，但在肌腱宏观健康区域也检测到。在水肿的腱旁组织中，血管壁富含纤连蛋白，脂肪细胞被纤连蛋白勾勒出轮廓。在腱旁组织中也经常见到纤连蛋白均匀沉积的区域。在破裂部位也观察到大量纤连蛋白。目前的结果表明，退变的肌腱和腱旁组织中结缔组织的组成有显著变化。这些变化似乎增加了肌腱断裂的易感性。
