激素性骨坏死血管变化的实验研究  

Changes of vessel in steroid-induced osteonecrosis of femoral head: experimental study of rabbits

作　　者：王坤正[1] 王春生[1] 武永刚[1] 陈虹[1] 

机构地区：[1]西安交通大学第二医院骨科,710004

出　　处：《中华医学杂志》2006年第29期2024-2027,共4页National Medical Journal of China

摘　　要：目的观察激素性骨坏死动物血管功能障碍,血管损伤,血流粘滞和血管再生障碍变化的规律和过程。方法选用中国白兔随机分2组。A组:马血清加用甲基强的松龙组;B组:单用甲基强的松龙组。A、B组分别于用药前及最后一次用激素后3、7、21 d测定血浆内皮素(ET)、细胞间粘附分子-1(ICAM-1)和血栓调节蛋白(TM)。A组动物于首次注射血清1周,首次应用激素后1、3、5、7周;B组动物于首次注射激素后1、3、5、7周分批处死取双侧股骨头。常规HE染色和VEGF免疫组化染色。结果血清加激素组的变化较单纯应用激素组有更强的变化;血清加激素组动物ICAM-1和TM在应用激素后3周时已开始回复,而ET未见回复;2组动物的VEGF表达都表现为降低后逐渐回复的过程。结论应用激素后,股骨头普遍存在前坏死状态,这种情况具有一定的可恢复性,但恢复结果可能受多种因素影响,因而应对这类情况进行长期的观察。Objective To investigate the changes of vessel function, vessel injury, blood viscosity and vessel regeneration in steroid-induced osteonecrosis of femoral head. Methods Forty Chinese white rabbits were randomly divided into2 equal groups to be injected with： horse serum intravenously twice with an interval of 3 weeks and than prednisone inraperitoneally once a day for 5 days （Group A） , or injected with prednisone once a day for 5 days （Group B）. Whole blood samples were collected by intracordial puncture. before intravenous injection in group A and B, 24 hr after injection of horse serum in group A, and 3, 7, and 21 days after prednisone administration. Radioimmunological methods were used to detect the plasma endothelin （ET） and thrombomodulin （TM）, and ELISA was used to detect the plasma intercellular adhesion molecule-1 （ICAM-1. Some rabbits were killed before intravenous administration, 24 hrs after injection of horse serum in group A, and 3, 7, 21,35, and 49 days after the first treatment with prednisone respectively and their bilateral femoral heads were taken out to undergo HE staining and microscopy and SPVEGF immunohistochemistry. Results The levels of plasma TM, ET, and ICAM-1 gradually increased in comparison with those before treatment in both group, however, not significantly （all P 〉 0.05 ）. The levels of plasma TM 1 week and 3 weeks after the initial prednisone administration inn Group A were significantly higher than those in Group B （ both P 〈 0.05 ）. 3 weeks after the initial prednisone administration the levels of plasma ICAM-1 and TM began to decrease and were lower than those 1 week after, however, not significantly （both P 〉 0.05）. Pathological changes could be seen 1 and 3 weeks after in both groups and then recovered by the 7th week after the treatment. The level of VEGF expression in the osteocytes, osteoblasts, and cells of bone matrix and endothelial cells increased first 1 week after and then decreased after the prednisone administration in Group

关 键 词：股骨头坏死 内皮缩血管肽类 细胞粘着分子 血栓调节蛋白 内皮生长因子 

分 类 号：R681[医药卫生—骨科学] R783.5[医药卫生—外科学]