人β防御素-3在人工关节感染假体周围组织中的表达  

Expression of human beta-defensin-3 in surrounding tissues of infected artificial prostheses

作　　者：罗羲[1] 费军[3] 杜顺华[2] 黄显凯[3] 倪卫东[1] 

机构地区：[1]重庆医科大学附属第一医院骨科,重庆400016 [2]重庆医科大学附属第一医医务处,重庆400016 [3]第三军医大学附属大坪医院野战外科研究所创伤外科

出　　处：《中华创伤杂志》2013年第5期456-460,共5页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目（30700177,81071459）;重庆市科技攻关资助项目（CSTC,2009AC5022）;中国博士后基金资助项目（20090460108,201003775）;第三军医大学科技成果转化基金资助项目;重庆市医学科技计划资助项目（2008-2-44）

摘　　要：目的观察人B防御素一3（humanbeta—defensin-3，HBD-3）在人工关节感染（ periprosthetic joint infection,PJI）患者假体周围组织中的表达，探讨其对PJI诊断与治疗的价值。方法按临床诊断收集术中切取的假体周围组织和正常滑膜，并分为以下四组：PJI组（13例）、无菌性松动组（松动组，9例）、占位器治疗组（治疗组，12例）和正常组（15例）。采用HE染色观察炎性细胞浸润，免疫荧光染色观察阳性细胞数及强度并采用Image—proplus（IPP）7．0C软件测量平均吸光度值。收集术前外周血白细胞计数、红细胞沉降率（erythrocyte sedimentation rate,ESR）、C反应蛋白（C—reactive protein，CRP）结果。结果HE染色正常组无炎性细胞浸润，其余三组有不同程度炎性细胞浸润。PJI组免疫荧光染色阳性细胞最多、阳性程度最强。PJI组平均吸光度值最高（0．430±0．013），其次为松动组（0．308±0．005）、治疗组（0．234±0．009）及正常组（0．089±0．019）。术前PJI组外周血白细胞计数、ESR和CRP最高，其余三组差异无统计学意义。结论HBD-3在PJI和假体无菌性松动患者的假体周围组织中存在高表达，对于PJI诊断及其与假体无菌性松动的鉴别是一种较好的指标。Objective To observe expression of human beta-defensin-3 （HBD-3） in tissues around the infected artificial prostheses and investigate its value in treatment and diagnosis of periprosthetic joint infection （PJI）. Methods According to clinical diagnosis, periprosthetic tissues and normal synovial membrane excised in operation were collected and divided into the following four groups ： PJI group （n = 13）, aseptic loosening group （loosening group, n =9）, spacer treatment group （treatment group, n = 12）, and normal group （n = 15 ）. HE staining was used to observe infiltration of inflammatory cells. Immunofluorescence staining was used to detect positive cells number and fluorescence intensity. Image-pro plus （IPP） 7. OC software was used to measure the average value of absorbance. Preoperative peripheral white blood cell count, erythrocyte sedimentation rate （ESR）, and C- reactive protein （CRP） results were documented. Then, differences of those parameters were analyzed and compared among groups. Results HE staining revealed that all groups had different degree of inflammatory cell infiltration except for normal group. Immunofluorescence staining revealed that the most number of positive cells and highest fluorescence intensity existed in PJI group. Value of absorbance in PJI group was 0.430 ± 0.013, followed by 0.308 ± 0. 005 in loosening group, 0. 234 ±0. 009 in treatment group, and 0. 089 ± 0. 019 in normal group. Preoperative peripheral white blood cell count, ESR and CRP were the highest in PFI group, but were not significantly different among the remaining three groups. Conclusion HBD-3 is highly expressed in tissues around the prostheses which had infection or aseptic loosening, but its expression in response to infection and loosening has difference.

关 键 词：感染 人工关节 防御素类 诊断 

分 类 号：R687.4[医药卫生—骨科学]