激素诱发骨坏死的免疫组织化学研究  

Immunohistochemical Study on Steroid-Induced Osteonecrosis

作　　者：杨万石[1,2] 王坤正[1,2] 王奎生[1,2] 郭瑞京 孙彤[1,2] 王新同 朱伟 王大民[1,2] 

机构地区：[1]北京煤碳总医院 [2]西安医科大学第二附属医院

出　　处：《中国骨伤》1999年第2期14-17,共4页China Journal of Orthopaedics and Traumatology

基　　金：陕西省自然科学基金

摘　　要：目的探讨激素治疗变态反应疾病过程中诱发骨坏死的发病机制。方法白兔４０只，静脉注射马血清（１０ｍｌ／ｋｇ）２次（２次间隔３周），建立变态反应模型。然后分为２组，第１组不予治疗，第２组在第２次注射马血清后２周，腹腔内注射强的松龙（４５ｍｇ／ｋｇ）连续３天，治疗“血清病”（ＩＩＩ型变态反应）。分别在１、２、３、５周时解剖取出双侧股骨头标本，采用ＡＢＣ直接法显示免疫复合物沉积的部位及免疫反应强度，光镜观察。结果强阳性的着色均发生在用激素治疗变态反应病组。不同的个体，免疫组织化学染色阳性反应愈强，骨组织细胞发生变性坏死的程度、范围愈大，骨坏死的发病率愈高。结论激素在治疗变态反应疾病过程中，加重血循环损害，抑制正常骨化。Objective To inquire into the pathogenesis of the osteonecrosis induced in the therapeutic process of allergic disease with steroid.Methods The allergic disease model of rabbit was established by intravenous injection of horse serum(10ml/kg)twice ,with an interval of 3 weeks.Forty modelized rabbits were divided into two groups:the first group without treatment;and the second group,2 weeks after the second injection of serum was injected intraperitoneally with prednisolone(45mg/kg)for 3 days in order to treat the “serum disease”(allergy type III).The bilateral specimens of femoral head were taken out at the first,second,third and fifth week,respectively,and the direct ABC method for immunohistochemistry was applied for observing the deposition site and intensity of the immune complex.Results The strong positive reaction was found in the steroid-treated group only.In different animals,the more intensive the immunohistochemical reaction was,the more severe and more extensive the degeneration and necrosis of bone and its cells were,and the more higher the occurrence of osteonecrosis was.Conclusion Prednisolone in the therapeutic process of allergic disease can damage the blood circulation more severely,inhibit the normal ossification and finally,induce the osteonecrosis.

关 键 词：糖皮质激素 骨坏死 变态反应 免疫组织化学 

分 类 号：R681.03[医药卫生—骨科学]