外周血干细胞动员后移植治疗股骨头缺血性坏死的疗效比较  

Effects of transplantation with mobilized peripheral blood stem cells on avascular necrosis of the femoral head

作　　者：姬钢[1] 宋焕瑾[2] 严少荣[1] 仉培武 王伟[2] 柏龙文[1] 武刚伟 

机构地区：[1]西安市中心医院骨科,西安710004 [2]西安交通大学第二附属医院骨科

出　　处：《山西医科大学学报》2014年第2期93-97,162,共6页Journal of Shanxi Medical University

基　　金：陕西省科技攻关基金资助项目(2011K12-72)

摘　　要：目的探讨外周血干细胞动员后移植治疗股骨头缺血性坏死的效果。方法将30只新西兰大白兔随机分为空白组、对照组和实验组;给予实验组兔重组人粒细胞刺激因子(CSF)0.2 ml/次,1次/d,进行外周血干细胞动员,在第7天后抽取外周血10 ml并对干细胞进行分离;对照组和实验组动物利用甲强龙联合内毒素法建立兔股骨头缺血性坏死模型并行MRI评价造模效果;造模6周后对照组和实验组动物行髓心减压术;并对实验组行自体外周血干细胞移植;术后6周观察动物一般情况,以及股骨头区骨组织血管情况,并行VEGF、BMP-2免疫组化染色。结果外周血干细胞动员后第7天外周血行单核细胞(MNC)为(21.20±2.11)×106/ml,CD34+阳性率为(2.97±1.43)%;动员后干细胞移植后实验组动物HE染色显示股骨头区新生血管较对照组增多,骨组织修复活动较对照组增强;免疫组化染色显示实验组表达VEGF、BMP-2较对照组明显增加。结论 CSF动员外周血干细胞可以得到足够的种子细胞,移植后可改善股骨头缺血性坏死区的微环境及血运,达到促进股骨头区组织的修复。Objective To explore the therapeutic effects of G-CSF-mobilized peripheral blood stem cell on avascular necrosis of the femoral head.Methods Thirty rabbits were randomly assigned into blank group,control group and experimental group.The peripheral blood stem cells in experimental group were mobilized using recombinant human granulocyte colony stimulating factor （rhG-CSF）,0.2ml every time every day;and 10 ml of peripheral blood was collected for isolation of stem cells at day 7.The rabbit model of methylprednisolone/endotoxin-induced avascular necrosis of femoral head was established in control group and experimental group,which was evaluated by MRI.Six weeks later,rabbits in both groups underwent core decompression.Besides,rabbits in experimental group underwent autologous peripheral blood stem cell transplantation.The rabbits were observed for six weeks after operation on general condition,angiogenesis at the femoral head area,immunohistochemistry stainings of VEGF,BMP-2.Results Seven days after peripheral blood stem cell mobilization,MNCs were （21.20 ± 2.11） x 106/ml and CD34 ＋ positive rate was （2.97 ± 1.43） ％.Morphological observation by HE-staining revealed that the rabbits in experimental group showed significantly more angiogenesis at the femoral head area and higher osteogenetic activity in bone repair tissue than that in control group.Immunohistochemical staining showed that the expression levels of VEGF,BMP-2 were significantly higher in experimental group than in control group.Conclusion G-CSF-mobilized peripheral blood stem cells may obtain enough seed cells.Transplantation of mobilized peripheral blood stem cells may improve the microenvironment and blood supply in the avascular necrosis areas,thus promoting the tissue repair of femoral head.

关 键 词：外周血干细胞 动员 股骨头缺血性坏死 

分 类 号：R681[医药卫生—骨科学]