速发型糖尿病致股骨头的病理变化  

Pathological changes of femoral head induced by immediate diabetes mellitus

作　　者：张开放[1] 刘军[1] 刘涛[1] 闫宏伟[1] 姚永锋[1] 李政[1] 

机构地区：[1]西安交通大学医学院附属第二医院骨科,陕西省西安市710004

出　　处：《中国组织工程研究与临床康复》2007年第36期7185-7189,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：陕西省科技攻关项目(2006K14-G4)~~

摘　　要：目的:观察糖尿病引发股骨头缺血性坏死的基本病理过程。方法:实验于2006-03/12在西安交通大学医学院附属第二医院骨病研究所实验室完成。①实验分组:70只日本大耳白兔随机分为对照组18只,实验组52只。②实验方法:对照组18只给予生理盐水5mL耳缘静脉注射。实验组52只造模前再次称重后,按130mg/kg四氧嘧啶耳缘静脉快速推入,建立速发型糖尿病动物模型。造模成功48只。实验组及对照组动物分别于第4周、第8周、第12周分批麻醉后处死,对照组每次6只,实验组每次16只。股骨头标本于采血后立刻解剖留取。③实验评估:不同时期光镜下观察组织病理学变化;透射电镜超微形态变化;测定血流变学指标;测定血液生化指标;测定血小板功能指标。结果:①光镜下组织病理学观察:实验组第4周时2只动物出现骨小梁结构紊乱,空缺骨陷窝数增多为14%;第8周时3只动物出现骨小梁结构部分断裂、消失,空缺骨陷窝数增多为28%;第12周时5只动物出现骨小梁结构断裂消失更明显,空缺骨陷窝计数高达56%。②透射电镜超微形态观察:透射电镜下观察骨细胞内出现大小不等的脂滴,骨细胞呈不同程度的坏死。骨髓组织增生减低,脂肪细胞增多、增大。③血流变学指标测定结果:实验组血液流变学各指标含量高于对照组(P<0.05或P<0.01)。④血小板功能指标测定结果:血浆血小板聚集试验、α-颗粒膜蛋白含量高于对照组(P<0.05或P<0.01)。⑤血液生化指标测定结果:第8、12周时血清钙含量低于对照组(P<0.05或P<0.01)。血清磷含量高于对照组(P<0.05或P<0.01)。钙磷乘积在12周时下降明显(P<0.05)。血清总胆固醇、三酰甘油含量高于对照组(P<0.05或P<0.01)。结论:糖尿病引起血液高黏滞和血液高凝导致严重微循环障碍、引起骨质疏松、高脂血症、早期发生血流变异常及血小板功能的异常。随着糖尿病病程的延AIM： To explore the elementary pathological process of ischemic necrosis of femoral head induced by diabetes mellitus. METHODS： The experiment was performed at the Osteonosus Institute, Second Hospital of Xi＇an Jiaotong University Medical School from March to December 2006. ①Seventy Japanese White Rabbits were randomly divided into control group （n =18） and experimental group （n =52）. ②The rabbits in control group were injected with 5 mL normal saline. The experimental group was injected with 130 mg/kg Alloxan through ear-edge vein quickly to establish the immediate diabetes mellitus model. Totally 48 rabbits were successfully modeled. Then 6 animals of control group and 16 ones of experimental group were executed respectively at the 4^th, 8^th and 12^th weeks under aesthesia to harvest the femoral head samples after taken blood. ③Histopathology, ultrastructure, biochemistry, hemorrheology, and platelet function in different ages were detected. RESULTS： In the experiment group, bone trabecula of 2 rabbits was found disorder, and vacant bone lacuna was increased to 14% in the 4^th week; In the 8^th week, part bone trabecula of 3 animals was found breakage, defluxion, and vacant bone lacuna was increased to 28%; In the 12^th week, bone trabecula of 5 animals was found breakage obviously, and vacant bone lacuna reached to 56%. ②Under transmission electron microscope, there were lipid droplets in bone cells with different sized, and bone cellular necrosis at different levels. Myelosis was decreased and the number and diameter of adipose cell were increased. ③Every index of hemorheology in experimental group was higher than that in control group （P 〈 0.05 or 0.01）.④Platelet agglutination test, alpha-granule membrane protein content of experimental group were higher than those in control group （P 〈 0.05 or 0.01）. ⑤In the 8^th and 12^th weeks, there was a decrease in serum calcium in experimental group compared with control group （P 〈 0.05 or 0.01）, but an increase in seru

关 键 词：糖尿病 股骨头病理变化 兔 

分 类 号：R587.1[医药卫生—内分泌]