儿童股骨头坏死患髋软骨蛋白多糖及滑液血清透明质酸的生物化学研究  

Cartilage Proteoglycans and Hyaluronic Acid Levels in Serum and Synovial Fluid in Femoral Head Necrosis in Children

作　　者：李旭东[1] 王坤正[1] 陈君长[1] 李幼芬[1] 党晓谦[1] 刘忠堂[1] 庞炜 朱利[1] 

机构地区：[1]西安医科大学第二附属医院骨科,710004

出　　处：《中华小儿外科杂志》1999年第3期159-161,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的研究股骨头坏死患儿患髋的生物化学改变，分析关节功能状态在疾病中所起的作用。方法本实验运用放射免疫学方法检测了２０例儿童股骨头坏死患髓软骨，１０例与患儿年龄相当的尸体同部位软骨的蛋白多糖（ＰＧ）三组份：氨基己糖、己糖醛酸、硫酸基含量和患儿关节腔液及外周血清透明质酸（ＨＡ）含量，并分别与正常对照组相比较，同时分析软骨ＰＧ、关节腔液和血清ＨＡ三者相互之间的相关性。结果①儿童股骨头坏死患儿软骨ＰＧ三组份含量较正常对照明显下降（Ｐ＜０．０１）；②股骨头坏死患儿血清ＨＡ浓度明显高于正常对照组（Ｐ＜０．０１），关节腔液ＨＡ与血清ＨＡ呈负相关（ｒ＝－０．６６３，Ｐ＜０．０５）；③股骨头坏死患儿关节腔液ＨＡ浓度与软骨ＰＧ含量均呈正相关（ｒ＝０．６８２，Ｐ＜０．０５）；软骨ＰＧ含量与血清ＨＡ浓度呈负相关（ｒ＝－０．６３２，Ｐ＜０．０５）。结论①儿童股骨头坏死患髓关节功能有明显障碍；②血清ＨＡ对于儿童股骨头坏死病可在一定程度上反映软骨功能状态；③关节功能障碍与股骨头坏死病变相互促进，恶性循环。Objective To evaluate the biochemical changes in cartilage of Perthes disease. MethodsAbnormal cartilage was sampled from 240 patients with steroid induced avascular necrosis of femoral head(ANFH) (stage II --III, Fiact classification). Healthy cartilage was collected from the same sites from 10age matched cadavers as controls. Cartilage proteqlycans (PG) (hexenine, hexuronic acid, sulfate radical) and hyaluronic acid (HA) levels in synovial fluid and serum were determined with radioimmunoassay.Results Children with ANFH had sighficantly reduced PG level than that of the controls (P < 0. 01 ).Serum HA level in children with ANFH was higher than that of controls (P< 0. 01 ) and there was a negative correlation between the HA levels in serum and synovial fluid (r = - 0. 663, P< 0. 05). There was apositive correlation between the synovial fluid HA and cartilage PG (r = 0. 682, P<0. 05); whereas therewas a negative correlation between the cartilage PG and serum HA (r = - 0. 632, P< 0. 05). ConclusionsANFH affects hip joint function. Serum HA reflects the state Of cartilage to certain extent. ANFH anddysfunction of the joint form a vicious circle.

关 键 词：蛋白多糖 透明质酸 股骨头坏死 髋软骨 儿童 

分 类 号：R726.818[医药卫生—儿科]