大剂量激素对兔股骨头内血管影响的研究  

The Research of Intraosseous Blood Vessels of the Femoral Head with a large Dosages Glucocorticoid in Rabbit

作　　者：张建色[1] 张崇智[1] 姜文学[2] 

机构地区：[1]天津医科大学人体解剖学教研室,天津300070 [2]天津市第一中心医院骨科,天津300192

出　　处：《实用骨科杂志》2009年第5期351-354,共4页Journal of Practical Orthopaedics

基　　金：天津市科技发展计划项目(043111411)

摘　　要：目的通过动物实验观察单纯大剂量糖皮质激素对股骨头关节软骨下微血管变化的影响，探讨早期激素性股骨头缺血性坏死的发病机制。方法将24只12～18月龄健康日本白兔随机分成3组，实验组A组（n=9）：耳缘静脉单纯注射甲强龙．初始剂量30mg／kg，追加剂量5．4mg／kg·h，连续23h；实验组B组（n=9）：耳缘静脉单纯注射甲强龙8mg／kg·d，连续10d；对照组C组（n=6）不作任何处理。在应用激素后2、4、6周分别对实验组和对照组动物股骨头行明胶墨汁灌注、HE染色、免疫组织化学染色及图像分析等方法观察关节软骨下微血管形态、数目，直径与密度的变化。结果明胶墨汁灌注显示：A、B组股骨头关节软骨下区微血管数量明显减少，灌注不全；HE及免疫组织化学染色显示：A、B组关节软骨下微血管数量减少。部分管壁结构不完整，血管内有少量红细胞．可见红色血栓，无明显管腔狭窄；图像分析示关节软骨下微血管密度明显降低。结论大剂量激素可以引起股骨头内微血管数量减少．密度降低，管壁损伤，血管内血栓形成，这可能是早期激素性股骨头缺血性坏死的原因之一。Objective To observe the pathological changes of the blood vessels in articular cartilage of the femoral head in rahbit after injecting large dosages of glueocorticoid so as to investigate the pathogenesis of early steroid-induced avascular necrosis of the femoral head. Methods Twenty-four Japanese rabbits were randomly divided into three groups,namely group A：9 animals underwent megadose methylprednisolone infusion by ear vein （30 mg/kg intravenously as an initial bolus,followed by 5.4 mg/kg/h for further 23 h）,as recommended by the National Acute Spinal Cord Injury Studies（NASCIS）;group B： 9 animals were injected with 8 mg/kg of methylprednisolone,which lasted for 10 days. And 6 animals as control were not given any treatment. The experiment lasted for 6 weeks. The changes of blood vessels morphous ,number and diameter in articular cartilage were observed under optical microscope after gelatin-ink infusion,HE stain,immunohistochemical stain and image analysis. Results Compared with the normal control group.the number of perfused vessels in group A and B had significantly decreased,which was featured by defective perfusion;Vessel wall was not complete partly and blood vessel occlusion in HE and immunohistochemistry,and the lumina was not constrictive significantly. Image analysis showed that the blood vessel density was obviously decreased. Conclusion The number and density of vessels reduced,vascular wall structural damaged and intravascular thrombosis,which may be one of the reasons in early steroid-induced avascular necrosis of the femoral head.

关 键 词：股骨头 糖皮质激素 明胶墨汁 微血管 

分 类 号：R681.8[医药卫生—骨科学]