高能震波促进缺血性坏死股骨头BMP-2的表达  

Effect of high energy shock waves on expression of BMP-2 in adult rabbits with 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：《中国矫形外科杂志》2010年第3期241-245,共5页Orthopedic Journal of China

基　　金：国家自然科学基金(基金编号:30571898)

摘　　要：[目的]观察高能震波对缺血性坏死股骨头骨形态发生蛋白2(BMP-2)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38只,3.0～4.0 kg,平均3.3 kg。联合应用甲基强的松龙和内毒素6周诱发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0.26 mJ/mm2,频率1 Hz,冲击量为2 000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24 h和第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PCR、免疫组化染色,检测BMP-2的表达。[结果]高能震波治疗显著增加了兔股骨头骨组织中BMP-2 mRNA的表达,治疗侧股骨头BMP-2 mRNA的表达在治疗后第24 h以及第1、2、4、8周显著高于对照侧,在治疗后第1周BMP-2 mRNA的表达最高。高能震波治疗后4、8和12周,治疗侧股骨头BMP-2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4、8和12周,治疗侧股骨头BMP-2平均吸光度显著高于对照侧(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BMP-2的表达,可能有助于增加股骨头的骨生成,加速股骨头坏死的修复。[Objective]To investigate the effect of high energy shock waves on the expression of BMP-2 in adult rabbits with necrotic femoral head,and to explore the mechanism of avascular femoral head necrosis treated with high energy shock waves.[Methods]Thirty eight male adult New Zealand white rabbits,weighting 3.0 to 4.0 kg（average weight 3.3 kg） were used to establish animal model of avascular femoral head necrosis.Bilateral femoral head necrosis was induced by methylprednisolone and lipopolysaccharide.The left hind limbs（treatment side） of all rabbits received shock wave treatment of the femoral heads and the right limbs（control side） of all rabbits received no shock wave treatment.The animals were killed at 24 hours and 1（n=6）,2（n=6）,4（n=6）,8（n=6）,and 12（n=6） weeks after shock wave therapy.The femoral heads were harvested and freed of soft tissue and cartilage.They were assigned to immunohistochemistry and quantitative real-time reverse transcriptase PCR.[Results]Compared with the contrala...更多teral control without shock wave treatment,the BMP-2 mRNA expression levels increased to a peak at 1 week after the shock wave treatment and remained high at 24 hours and 1、 2、 4、 8 weeks after the shock wave treatment.At 4,8 and 12 weeks after shock wave treatment,the average percentage of staining area of the femoral heads in the treatment side were significantly higher than those in the control side（P〈0.01,P〈0.01,P〈0.01,）.At 4,8 and 12 weeks after shock wave treatment,the average optical density of the femoral heads in the treatment side were significantly higher than those in the control side（P〈0.01,P〈0.01,P〈0.01）.[Conclusion]High energy shock waves may have effect in promoting the expression of BMP-2 in necrotic femoral head of rabbit,increasing osteogenesis of the necrotic femoral head,and accelerating the repairing process of the femoral head necrosis.

关 键 词：股骨头坏死 糖皮质激素类 高能震波 骨形态发生蛋白 

分 类 号：R681.8[医药卫生—骨科学]