创伤后关节软骨细胞凋亡及其预防的实验研究  

Prevention of chondrocyte apoptosis following acute osteochondral injury

作　　者：董启榕[1] 宋长志[1] 

机构地区：[1]苏州大学附属第二医院骨科,215004

出　　处：《中华创伤骨科杂志》2006年第11期1043-1047,共5页Chinese Journal of Orthopaedic Trauma

基　　金：卫生部科研基金(WKJ2004-2-009)

摘　　要：目的探讨关节软骨创伤后软骨细胞凋亡情况及其预防方法。方法32只新西兰大白兔,4只行膝关节囊切开,不损伤软骨(正常组),另28只双侧膝关节钻孔造成软骨急性损伤,一侧关节腔在术毕和术后每周1次注射1％透明质酸钠1 mL(治疗组),另一侧不做处理作为损伤对照(损伤组);利用TUNEL、流式细胞仪两种方法检测软骨受损区软骨细胞凋亡情况。结果损伤后软骨细胞出现坏死和凋亡,至第4天软骨细胞凋亡率最大,凋亡细胞全层分布;透明质酸钠治疗组软骨细胞凋亡较损伤组明显减少,差异有极显著性意义(P<0．01)。结论创伤后关节软骨细胞发生凋亡会导致创伤后骨关节炎的发生。早期关节腔内注射透明质酸钠能有效抑制软骨细胞凋亡,可能对预防和降低创伤后骨关节炎的发生有重要意义。Objective To explore the characteristics of chondrocyte apoptosis following acute osteochondral injury and the effect of intra-articular sodium hyaluronate injection in prevention of chondrocyte apoptosis. Methods Acute osteochondral injuries were created by drilling holes in knees at both sides of 28 rabbits according to Costouros＇ method. The experimental and control sides were randomized in each animal. Another four rabbits served as a normal control which received dissection of knee joint capsule without osteochondral injury. The experimental knee was injected with 1% sodium hyaluronate at the end of the operation and then every week postoperatively. TUNEL and fluorescence-activated cell sorter （FACS） were applied to study the injured femoral condyles obtained at different intervals following the drilling injury. Results From day 4 after injury, the injured cartilage specimens displayed a statistically significant increase in overall level of apoptosis. Chondrocyte apoptosis was significantly reduced in the experiment knees compared with the injured ones. Conclusions Chondrocyte apoptosis may contribute to the subsequent development of post-traumatic arthritis. Intra-articular sodium hyaluronate injection just after acute osteochondral injury can suppress chondrocyte apoptosis, and thus help prevent the knee from post-traumatic arthritis.

关 键 词：关节软骨 创伤 细胞凋亡 预防 

分 类 号：R684[医药卫生—骨科学]