体外冲击波延缓兔膝骨性关节炎退变的实验研究  

Effect of extracorporeal shock wave on regression osteoarthritis degeneration in rabbit osteoarthritis

作　　者：赵喆[1,2] 安佰京[1] 李志国[1] 刘运晃[3] 邢更彦[1] 

机构地区：[1]武警总医院骨科,北京100039 [2]武警山西总队朔州支队,朔州市036002 [3]武警广东总队医院骨科,广州市510507

出　　处：《中国矫形外科杂志》2012年第21期1972-1975,共4页Orthopedic Journal of China

基　　金：国家自然科学基金资助项目(项目编号:31172169);武警总医院科研发展基金(编号:WZ2009052)

摘　　要：[目的]前期研究发现体外冲击波(extracorporeal shock wave,ESW)干预骨性关节炎(Osteoarthritis,OA)动物模型后,可缓解关节疼痛并能改善肢体功能。然而,ESW对OA软骨退变的影响未深入探讨。[方法]30只新西兰大白兔随机分为三组:对照组(n=6);ACLT组(n=12)和ESWT+ACLT组(n=12)。ESWT干预4、8周后,采用大体观察和组织学评价对兔膝OA的影响。[结果]ACLT组4、8周后表现出典型的OA病理变化。而ESWT+ACLT组4周兔膝关节软骨尚光滑,局部有轻微磨损,软骨分层结构尚可;8周后可见局部有较大磨损,软骨变薄,表面覆盖少量疏松的纤维组织,软骨表面部分修复,裂隙达到移形层,潮线不完整。ESWT+ACLT组在4周和8周Moran评分和Markin评分同相应时期ACLT组相比有统计学差异(P<0.05)。[结论]ESWT具有延缓OA退行性改变的作用,可作为防治OA的新方法,具有重要的临床意义。然而,在临床应用ESWT治疗OA患者,还需评估ES-WT的安全性,确定ESWT最佳能量参数和治疗时机以及其作用机制等问题。[ Objective] To investigate the impact of extracorporeal shock wave （ESW） on osteoarthritis （OA） cartilage degeneration. [ Methods] Thirty New Zealand white rabbits were randomly divided into three groups： control group （n = 6） ; ACLT group （n = 12） and ESWT ＋ ACLT group （n = 12） . After the intervention of ESWT, the rabbit knees were evaluated by gross observation and histological evaluation at 4 and 8 weeks. [ Results ] Rabbits in ACLT group after 4 weeks and 8 weeks showed a typical OA pathological changes. ESWT ＋ ACLT group of rabbit articular cartilage was still smooth, locally with minor wear, cartilage hierarchy was acceptable at four weeks. After 8 weeks, we found cartilage thinning, surface covered with a small amount of loose fibrous tissue, cartilage surface part of the repair, fracture of the transitional layer, the tide line was incom- plete. Moran and Markin score of ACLT ＋ ESWT group at 4 weeks and 8 weeks were statistically significant （P 〈 0. 05） com- pared with the corresponding period of ACLT group. [ Conclusion] ESWT can slow down the degenerative changes of OA, as new methods of prevention and treatment of OA, has important clinical significance. However, the clinical application of ESWT in treatment of OA patients need the safety assessment of ESWT, to determine the best energy parameters and timing of treatment or its mechanism of action.

关 键 词：体外冲击波 骨性关节炎 治疗 

分 类 号：R684.3[医药卫生—骨科学]