高能震波对兔缺血性坏死股骨头血管内皮生长因子表达的影响  

Effect of high energy shock wave on the expression of vascular endothelial growth factor in adult rabbits with avascular necrotic femoral head

作　　者：马焕芝[1] 曾炳芳[1] 李晓林[1] 柴益民[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,上海200233

出　　处：《中国康复医学杂志》2010年第1期13-18,共6页Chinese Journal of Rehabilitation Medicine

基　　金：国家自然科学基金资助项目(30571898)

摘　　要：目的:观察高能震波对缺血性坏死股骨头血管内皮生长因子(VEGF)表达的影响,探讨高能震波治疗股骨头缺血性坏死的作用机制。方法:健康雄性新西兰白兔32只,3.0-4.0kg,平均3.1kg。联合应用甲基强的松龙和内毒素6周诱发双侧早期股骨头缺血性坏死的动物模型。所有实验兔左后腿作为治疗侧,采用能流密度0.26mJ/mm2,频率1Hz,冲击量为2000次的高能震波治疗,右后腿作为对照侧,不予治疗。分别于治疗后第1、2、4、8、12周各取6只动物处死,取股骨头标本行实时荧光定量逆转录聚合酶链式反应(RT-PCR)、免疫组化染色,检测VEGF的表达。结果:高能震波治疗显著增加了兔股骨头骨组织中VEGF mRNA的表达,治疗侧股骨头VEGF mRNA的表达在治疗后第1、2、4和8周显著高于对照侧,在治疗后第2周VEGF mRNA的表达最高。高能震波治疗后第4、8和12周,治疗侧股骨头VEGF平均染色面积百分比显著高于对照侧(P<0.01,P<0.01和P<0.01)。高能震波治疗后第2、4、8和12周,治疗侧股骨头VEGF平均吸光度显著高于对照侧(P<0.01,P<0.01,P<0.01和P<0.01)。结论:高能震波治疗能有效促进缺血性坏死股骨头VEGF的表达,可能有助于增加股骨头的血管生成,加速股骨头坏死的修复。Objective： To investigate the effect of high energy shock wave on the expression of vascular endothelial growth factor（VEGF） in adult rabbits with avaseular necrotic femoral head, and to explore the mechanism of high energy shock wave treated on avaseular femoral head necrosis. Method： Thirty-two male adult New Zealand white rabbits, weight 3.0 to 4.0 kg （average weight 3.1 kg） were used to establish rabbit models of avaseular femoral head necrosis. Bilateral femoral head necrosis was induced by methylprednisolone and endotoxin. The left hind limbs （treatment sides） of all rabbits received high energy shock wave treatment on femoral heads and the right limbs （control sides） of all rabbits received no shock wave treatment. The rabbits were sacrificed at the 1st （n=6）, 2nd （n=6）, 4th （n=6）, 8th （n=6） and 12th （n=6） week after shock wave therapy respectively. The femoral heads were harvested and freed of soft tissue and cartilage. Immunohistochemistry staining and quantitative real-time reverse transeription-polymerase chain reaction （RT-PCR） techniques were used for the detection of VEGF. Result：Compared with the contralateral control without high energy shock wave treatment, the VEGF mRNA expression levels increased to high level at the 1st, 2nd, 4th, 8th week after treatment and reached to the peak at the 2nd week after treatment. At the 4th,8th and 12th week after treatment, the average percentage of VEGF staining areas of femoral heads in treatment sides was significantly higher than those in control sides （P〈0.01 ,P〈 0.01,P〈0.01,）. At the 2nd,4th,Sth and 12th week after treatment, the VEGF average optical density of the femoral heads in treatment sides was significantly higher than that in control sides（P〈0.01,P〈0.01,P〈0.01,P〈0.01, ）. Conclusion： High energy shock wave may provide the effect of promoting the expression of VEGF in necrotic femoral head of rabbit, increasing angiogenesis of necrotic femoral head, and accelerating the repairing

关 键 词：股骨头坏死 糖皮质激素类 高能震波 血管内皮生长因子 

分 类 号：R681.8[医药卫生—骨科学]