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类风湿性滑膜炎的组织学分类与实验性免疫性滑膜炎的细胞动力学及形态学比较(作者译)

[Histological classification of rheumatoid synovitis compared with cell-kinetics and morphology of experimental immune synovitis (author's transl)].

作者信息

Dreher R, Görnert C, Macholt U, Rohrbach B, Federlin K

出版信息

Immun Infekt. 1981 Nov;9(6):204-12.

PMID:7338349
Abstract

During the course of the experimental immune arthritis of the guinea pig four phases can be distinguished: I=fibrinopurulent, partly ulcerative synovitis, II=granulocytic activee granulomatous synovitis, III=lymphocytic activ granulomatous synovitis, IV=synovitic sequelae with subintimal fibrosis. On the basis of cell-kinetic studies with initial and systemic labelling with 3H-thymidine of the synovial membrane and of the bone marrow it could be demonstrated that in this model the infiltrating cells as well as the structural cells belong to the monocyte-macrophage system. The typical multilayer of the lining cells of this immune synovitis therefore seems to be mainly as a type A cell hyperplasia of bone marrow derived cells instead of a local proliferation of the lining cells. Clinical cases of various joint diseases are described including symptoms, X-ray findings and histopathological studies. Depending on the stage of the clinical course and the number, localization and activity of the macrophages within the synovial membrane the reaction pattern can be classified in a new way using the categories mentioned above in the experimental model. Thus the classical picture of rheumatoid arthritis corresponds to the synovitis of the subintimal type. The polyarthritic syndrome which mostly is pathogenetically unclear in contrast is designated as synovitis of the intimal type. The same holds true for the activated arthrosis.

摘要

在豚鼠实验性免疫性关节炎病程中,可区分出四个阶段:I = 纤维蛋白脓性、部分溃疡性滑膜炎;II = 粒细胞性活跃性肉芽肿性滑膜炎;III = 淋巴细胞性活跃性肉芽肿性滑膜炎;IV = 伴有内膜下纤维化的滑膜炎后遗症。通过对滑膜和骨髓进行3H - 胸腺嘧啶核苷初始和全身标记的细胞动力学研究表明,在该模型中,浸润细胞以及结构细胞均属于单核细胞 - 巨噬细胞系统。因此,这种免疫性滑膜炎衬里细胞的典型多层结构似乎主要是骨髓来源细胞的A型细胞增生,而非衬里细胞的局部增殖。文中描述了各种关节疾病的临床病例,包括症状、X线表现和组织病理学研究。根据临床病程阶段以及滑膜内巨噬细胞的数量、定位和活性,可利用上述实验模型中的类别以一种新的方式对反应模式进行分类。因此,类风湿性关节炎的典型表现对应于内膜下型滑膜炎。相比之下,大多病因不明的多关节炎综合征则被称为内膜型滑膜炎。活化性关节病也是如此。

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