前交叉韧带切除后半月板变化及α2-巨球蛋白干预效果的初步研究  

The effects of alpha 2-macroglobin on the meniscus after the transection of anterior cruciate ligament

作　　者：林子洪[1] 何爱珊[1] 傅明[1] 吴昶皓[2] 黄晓波[2] 范大渊[2] 刘毛毛[2] 盛璞义[1] 廖威明[1] 

机构地区：[1]中山大学附属第一医院骨科-显微外科医学部(黄埔关节外科中心),广州510080 [2]中山大学中山医学院

出　　处：《中华关节外科杂志（电子版）》2010年第1期59-62,共4页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：国家自然基金项目(30872615);广东省自然科学基金项目(8151008901000083);中山大学实验室开放基金资助项目(KF200724);2009年教育部大学生创新训练基金资助项目(091055853);医科2009年第一批和第二批学生业余科研资助项目

摘　　要：目的探讨兔骨关节炎(OA)模型膝关节前交叉韧带切除(ACLT)术后半月板的变化,及对关节腔内注射α2-巨球蛋白(α2M)对该变化的干预情况。方法健康的新西兰大白兔24只,按随机数字表分成5个时间点组,前2组各6只,后3组各4只,双侧膝关节自体对照。ACLT术后4、8、11和15周时,左侧膝关节注射用无菌生理盐水稀释成145mg/L的α2M为治疗侧,右侧膝关节注射等量无菌生理盐水为阴性对照侧,每次每侧0.4ml。术后4、8、11、15和21周行膝关节正侧位X光检查、半月板masson染色和电镜检查。结果ACLT模型建立成功,建模的时间越长,阴性对照侧的半月板病变越明显,ACLT后21周时,双侧膝未见明显关节间隙、骨赘及骨缺损等改变,而masson染色和电镜观察结果显示双侧关节半月板组织结构和细胞结构在4周时已发生较轻微的病理改变。与α2M治疗侧比较,阴性对照侧8～21周间半月板病变加重,21周后阴性对照侧的病变转变为不可逆的损伤;与阴性对照侧比较,α2M治疗侧的半月板退变速度稍慢,半月板纤维和细胞情况较好,但伴有滑膜的增生、侵袭。结论α2M可以减缓动物模型关节炎病变的进展速度,对滑膜增生的抑制作用较弱,α2M可能适合OA发病初期的保护性治疗和研究。Objective To investigate the pathological changes of meniscus in the rabbit osteoarthritis （OA） model by anterior cruciate ligament transection （ACLT）, and observe the curative effect of α2-maeroglobin （ α2M ） injected into the joint cavity. Methods 24 New Zealand rabbits were divided into 5 time-point groups by random digits table. The first two groups each had 6 rabbits, and the last three groups each had 4 rabbits. Left knee received 0.4 ml of 145 mg/L α2M at 4, 8, 11, 15 weeks postoperation as experimental side, while the right side received a same dosage of saline as control. X-ray examination of A-P ＆ lateral plain of knee joint were taken in 4, 8, 11, 15 and 21 weeks after operation, and the rabbits were sacrificed at each time point. Gross injury score of femoral cartilage, masson staining and electron microscope examination of the meniscus were carried out. Results The ACLT model was successfully established. The pathological changes of the meniscus of the negative control were more and more severe as the time went on. In 21weeks after ACLT, there were no obvious changes of the joint space, osteophyte and bone defect in both knees. But the tissue structure and cells of the meniscus had slightly pathological changes in 4 week by masson staining and electron microscope examination. Compared with ot2M experimental sides, the degenerative change of meniscus of the control sides became more obvious during 8 -21 weeks, and resulted in destructive changes and non-reversible injury after 21 weeks. Compared with the control group, the fibrin and cell structure of the meniscus was better in experimental group, although with hyperplasia and invasion of synovial membrane. Conclusions α2M could delay the aggregation of the pathological change of the OA model, but had little effect on the synovial membrane. α2M might be suitable for the treatment of OA at the early stage, and might have a bright future in the research field.

关 键 词：兔 骨关节炎 α巨球蛋白类 前交叉韧带 

分 类 号：R687.4[医药卫生—骨科学]