激素治疗Ⅲ型变态反应疾病诱发骨坏死的病理学研究  

Histopathologic study on the osteonecrosis of type Ⅲ allergosis induced by steroid

作　　者：杨万石[1,2] 王坤正[1,2] 陈君长[1,2] 王春生 

机构地区：[1]西安医科大学第二附院骨科 [2]北京煤碳总医院骨科

出　　处：《临床骨科杂志》1999年第1期1-3,共3页Journal of Clinical Orthopaedics

基　　金：陕西省自然科学基金

摘　　要：目的探讨激素致股骨头缺血坏死的发病机制。方法随机分单纯变态反应组（Ａ组）和激素治疗变态反应组（Ｂ组）。Ａ组采用分２次间隔３周给实验白兔ｉｖ马血清（１０ｍｌｋｇ－１）建立变态反应疾病模型。Ｂ组采用与Ａ组同样的方法，建立变态反应疾病模型，在模型建立后２周，连续３天腹腔内注射强的松龙（４５ｍｇｋｇ－１）。两组在处理完后第１、２、３、５周时取双侧股骨头标本，作大体观察，ＨＥ和Ｍａｓｓｏｎ三色染色，光镜观察。结果Ａ组：骨组织发生溶骨性骨坏死和血管炎，但增生修复反应活跃。Ｂ组：骨组织细胞发生慢性缺血坏死，骨小梁板层结构清楚；血管壁增厚，管腔狭窄，无明显增生修复反应。结论激素在治疗变态反应疾病过程中损害了股骨头的血供，抑制了骨组织细胞的代谢，从而抑制了机体对已发生坏死骨组织的修复重建，导致骨坏死发生。Objective To study the mechanism of steroid induced osteonecrosis. Methods White rabbits were divided into allergosis group(group A) and allergosis treated by steroid group(group B). In group A, the model of allergosis was established by intravenous injection of horse serum twice at the interval of 3 weeks. In group B, the model of allergosis was also established by the same method as group A. After 2 weeks, group B was injected with prednisone at 45 mg·kg -1 for 3 days abdominally. In the 1st, 2nd, 3rd and 5th week the samples of bilateral femoral heads were taken and observed with HE and Masson threecolour staining in both groups. Results In group A, osteolytic necrosis and vasculitis appeared and the reconstruction existed. In group B, the ischemic necrosis of bone cells, the thicked wall and stenosis of blood vessels, and the clear structure of bone trabeculae were found, but no reconstruction was seen. Conclusion Allergosis treated by steroid disturbed the blood supply of femoral heads, hindered the bone metabolism and reconstruction of necrotic bone, and caused osteonecrosis.

关 键 词：糖皮质激素 病理学 激光疗法 股骨头 缺血性坏死 

分 类 号：R681.802[医药卫生—骨科学] R593.106[医药卫生—外科学]