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目的探讨大骨节病关节软骨胶原表型表达的变化特点和软骨细胞异常分化在发病中的意义。方法用单克隆免疫组化法测定５例大骨节病关节软骨Ⅰ、Ⅱ、Ⅲ、Ⅵ、Ⅹ型胶原表型的表达。结果（１）关节软骨表层的Ⅱ型胶原表型表达减少；（２）Ⅰ、Ⅲ和Ⅵ型胶原表型表达见于关节软骨全层，而Ⅹ型胶原仅限于关节软骨钙化层和深层软骨细胞团周围；（３）软骨细胞团有Ⅰ、Ⅱ、Ⅲ、Ⅵ型胶原表型表达，而软骨细胞坏死区内无任何胶原表型表达。结论大骨节病关节软骨胶原表型表达类似于原发性骨关节病的变化，但在关节软骨表层Ⅰ型胶原表型表达增强以及软骨坏死区内无任何胶原表型表达不同于原发性骨关节病。
OBJECTIVE: To investigate the changes of the phenotype expression of articular cartilage collagen in Kashin-Beck disease and the significance of abnormal differentiation of chondrocytes in the pathogenesis. Methods The expression of collagen type Ⅰ, Ⅱ, Ⅲ, Ⅵ and Ⅹ in articular cartilage of 5 patients with Kovrol’s disease were determined by monoclonal immunohistochemistry. Results (1) The expression of type Ⅱ collagen in the surface of articular cartilage was decreased. (2) The expression of type Ⅰ, Ⅲ and Ⅵ collagen was found in the whole layer of articular cartilage. Type Ⅹ collagen was restricted to articular cartilage calcification and deep cartilage cell mass (3) Chondrocyte clusters expressed collagen type Ⅰ, Ⅱ, Ⅲ and Ⅵ, while there was no collagen phenotype in the area of chondrocytes necrosis. Conclusion The expression of collagen in articular cartilage of Kashin-Beck disease is similar to that of primary osteoarthrosis. However, the expression of type Ⅰ collagen phenotype in articular cartilage surface and the expression of collagen type in cartilage necrosis area are different from that of primary bone Joint disease.