辛伐他汀对早期激素性股骨头坏死的预防作用  

Preventive Effects of Simvastatin on Glucocorticoid-induced Early Necrosis of Femoral Head

作　　者：敦先礼[1] 李锋[1] 方忠[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院骨科,武汉430030

出　　处：《华中科技大学学报（医学版）》2006年第3期346-349,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的了解辛伐他汀对动物激素性股骨头坏死的防治作用。方法健康成年新西兰兔40只,随机分为4组(A、B、C、D组),每组10只。A组每天一次肌注2.5 mg/kg地塞米松;B组每天一次肌注2.5 mg/kg地塞米松和每天一次口服20 mg辛伐他汀;C组每天一次口服20 mg辛伐他汀;D组为对照组,肌注等量生理盐水。分别于4、6、8、10、14周检测血清胆固醇、三酰甘油、骨钙素(OCN)、抗酒石酸酸性磷酸酶(TRAP-5b)含量,分批处死后行X线摄片及组织学观察。结果A组中血清胆固醇、三酰甘油、TRAP-5b含量显著高于其它3组(均P<0.01);而OCN含量显著低于其它3组(均P<0.01);并且含辛伐他汀治疗组中影像学无股骨头坏死表现且组织学显示髓内脂肪堆积明显减少、骨小梁增粗、骨陷窝空虚率减少,无明显软骨板下骨组织结构紊乱骨坏死。结论辛伐他汀通过降低血脂和调节骨细胞自身的脂肪代谢紊乱及骨代谢平衡,对早期激素性股骨头坏死的发生、发展有一定的防治作用。Objective To study the preventive effects of simvastatin on the glucocorticoid-induced early necrosis of femoral head in rabbits. Methods Forty new Zealand adult rabbits were randomly divided into 4 groups. In group A, 10 rabbits were subjected to the intramuscular injection of dexamethasone 2.5 mg/kg every day; In group B, 10 rabbits were subjected to steroids as in group A plus simvastatin 20 mg per animal every day orally. In group C, 10 rabbits were treated with Simvastatin only （20 mg per animal per day）. In group D, 10 rabbits received no injections and served as the control group. All animals were sacrificed at intervals between 4 and 14 weeks. Serum cholesterol, triglyceride, osteocalcin and tartrate-resistant acid phosphatase were measured before the treatment and at intervals between 4 and 14 weeks after treatment. The histopathological changes of the femoral head of rabbits were observed under light microscopy and radiography. Results In group A, the levels of serum cholesterol, triglycerid and tartrate-resistant acid phosphatase were obviously higher than those in the other groups （P〈 0.01）, but osteocalcin levels were obviously lower than that in the other groups （P〈0.01）. A femoral head from a rabbit trea ted with steroid for 14 weeks showed subchondral bone death with structural disorganization, whereas that with simvastatin had no subchondral bone death with structural disorganization. Conclusion Simvastatin can regulate the disorder of lipometabolism for the osteoblast and the balance of bone metabolism, at the same time it can prevent the development of early necrosis of femoral head.

关 键 词：辛伐他汀 股骨头坏死 

分 类 号：R681.8[医药卫生—骨科学]