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关节镜治疗后,肱二头肌长头肌腱病合并肩部疾病时新生血管形成过程与疼痛强度的比较。免疫组织化学辅助显微镜评估。

Process of neovascularisation compared with pain intensity in tendinopathy of the long head of the biceps brachii tendon associated with concomitant shoulder disorders, after arthroscopic treatment. Microscopic evaluation supported by immunohistochemical.

作者信息

Zabrzyński J, Paczesny Ł, Łapaj Ł, Grzanka D, Szukalski J

机构信息

Department of Orthopaedic Surgery, Multidisciplinary Hospital Inowrocław, Poland.

出版信息

Folia Morphol (Warsz). 2018;77(2):378-385. doi: 10.5603/FM.a2017.0093. Epub 2017 Oct 24.

Abstract

BACKGROUND

Tendinopathy of the long head of the biceps brachii tendon (LHBT) is one of the most common, painful conditions of the anterior part of the shoulder and often coexists with rotator cuff tears. Multifactorial aetiopathology of tendi-nopathy is poorly understood; however, several studies indicated that it is seen predominantly in areas with decreased vascularity of the tissue; the pathology is also characterised by expansive and abundant neovascular in-growth. The aim of the study was to investigate the relationship between the neovascularisation of proximal part of the LHBT and pain along the bicipital groove.

MATERIALS AND METHODS

Tissue material was obtained from 28 patients who underwent a shoulder arthroscopy and experienced pain along the bicipital groove measured using Visual-Analog Scale (VAS) score. CD31 and CD34 molecules were visualised by immunohistochemical method to assess biceps tendon neovascula-risation and quantify it based on a Bonar scoring system.

RESULTS

Although all patients reported pain prior to arthroscopy (mean VAS score was 7.5), microscopic examination did not reveal neovascularisation in all cases. Immunohistochemical staining for CD31 and CD34 allowed for very precise visualisation and quantification of neovascularisation; however there was also no correlation between vessels in-growth scores and pain.

CONCLUSIONS

The obtained data suggest that neovascularisation process in tendino-pathy is not directly related to pain; however, further studies are needed to explain its significance in the LHBT tendinopathy. (Folia Morphol 2018; 77, 2: 378-385).

摘要

背景

肱二头肌长头肌腱(LHBT)腱病是肩部前部最常见的疼痛病症之一,常与肩袖撕裂并存。腱病的多因素病因病理尚不清楚;然而,多项研究表明,它主要见于组织血管减少的区域;其病理特征还包括大量新生血管向内生长。本研究的目的是探讨LHBT近端新生血管形成与肱二头肌沟疼痛之间的关系。

材料与方法

组织材料取自28例接受肩关节镜检查且有肱二头肌沟疼痛的患者,疼痛程度采用视觉模拟量表(VAS)评分。采用免疫组化方法观察CD31和CD34分子,以评估肱二头肌腱新生血管形成情况,并根据博纳尔评分系统进行量化。

结果

尽管所有患者在关节镜检查前均报告有疼痛(平均VAS评分为7.5),但显微镜检查并非在所有病例中均发现新生血管形成。CD31和CD34的免疫组化染色能够非常精确地观察和量化新生血管形成;然而,血管向内生长评分与疼痛之间也没有相关性。

结论

所获数据表明,腱病中的新生血管形成过程与疼痛无直接关系;然而,需要进一步研究以解释其在LHBT腱病中的意义。(《形态学杂志》2018年;77卷,第2期:378 - 385页)

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