信号传导及转录激活因子1诱导骨细胞凋亡在激素性股骨头坏死过程中的作用  

Effect of bone cell apoptosis induced by signal transducers and activators of transcription-1 in the process of steroid-induced necrosis of femoral head

作　　者：许心弦[1] 温宏[1] 吕杨训 胡月正[1] 余华晨[1] 潘孝云[1] 

机构地区：[1]温州医科大学附属第二医院,浙江温州325027

出　　处：《中医正骨》2014年第2期3-7,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：温州市科技局资助项目(Y20120252)

摘　　要：目的:探讨信号传导及转录激活因子1诱导细胞凋亡在激素性股骨头坏死过程中的作用。方法:选择30例激素性股骨头坏死组织标本,FicatⅠ期和Ⅱ期患者10例(A组)、FicatⅢ期患者10例(B组)、FicatⅣ期和Ⅴ期患者10例(C组),同时选择10例接受股骨颈骨折内固定手术的正常股骨头组织标本(D组)。对所有标本在光镜下观察测定空骨陷窝率,采用TUNEL凋亡检测法测定细胞凋亡率,分别采用免疫组化法和ELISA法对磷酸化信号传导及转录激活因子1的表达进行定性和定量检测,同时分别对细胞凋亡率与空骨陷窝率和磷酸化信号传导及转录激活因子1表达量进行相关性分析。结果:4组患者股骨头空骨陷窝率比较,差异有统计学意义[(29.10±6.14)%,(54.10±7.33)%,(75.25±7.80)%,(7.20±1.32)%,F=227.614,P=0.000];A组空骨陷窝率高于D组(P=0.000),B组高于A组(P=0.000),C组高于B组(P=0.000)。4组患者股骨头细胞凋亡率比较,差异有统计学意义[(5.70±3.27)%,(36.90±9.53)%,(70.30±13.63)%,(2.80±2.57)%,F=136.004,P=0.000]。A组和D组比较,差异无统计学意义(P=0.209);B组高于A组(P=0.000),C组高于B组(P=0.000)。4组患者股骨头磷酸化信号传导及转录激活因子1定性检测结果比较,差异有统计学意义[(3.15±0.82),(5.97±1.01),(8.56±0.94),(1.00±0.56),F=150.005,P=0.000]。A组高于D组(P=0.000),B组高于A组(P=0.000),C组高于B组(P=0.000)。4组患者股骨头磷酸化信号传导及转录激活因子1定量检测结果比较,差异有统计学意义[(1.86±0.43),(5.04±2.24),(11.14±2.49),(1.00±0.28),F=73.466,P=0.000]。A组高于D组(P=0.000),B组高于A组(P=0.000),C组高于B组(P=0.000)。空骨陷窝率和细胞凋亡率呈正相关(rs=0.882,P=0.000),细胞凋亡率和磷酸化信号传导及转录激活因子1表达量呈正相关(rs=0.860,P=0.000)。结论:骨细胞凋亡是激素性股骨头坏死的重要过程,并且信号传导及转录激活因子1可能在其中发挥了重要作用。Objective：To explore the effect of bone cell apoptosis induced by signal transducers and activators of transcription-1 （STAT1） in the process of steroid-induced necrosis of femoral head （SNFH）.Methods： The tissue samples of femoral head were fetched from 30 patients with SNFH.Ten patients（Group A）were categorized as Ficat phase Ⅰ or Ⅱ,10 patients（Group B）as Ficat phase Ⅲ,10 patients （Group C）as Ficat phase Ⅳ or Ⅴ.Meanwhile,ten normal bone tissue samples （Group D）were obtained from internal fixation surgery for femoral neck fractures.All the samples were observed under the optical microscope and the empty bone lacuna rate were measured,then the TUNEL apoptotic detection method were used to detect the apoptosis rate.After that,qualitative and quantitative detection on the expression of phosphorylated STAT1 （p-STAT1）were carried out by immunohistochemical method and ELISA method respectively.Meanwhile,correlation analysis were applied to study the relationship between empty bone lacuna rate and apoptosis rate and between empty bone lacuna rate and p-STAT1 expression.Results：There was statistical difference in the empty bone lacuna rate of femur head among the 4 groups （29.10 ＋/-6.14%,54.10 ＋/-7.33%,75.25 ＋/-7.80%,7.20 ＋/-1.32%,F =227.614,P =0.000）.The empty bone lacuna rate was higher in group A compared with group D （P =0.000）,was higher in group B compared with group A （P =0.000）,and was higher in group C compared with group B （P =0.000）.There was statistical difference in the apoptosis rate of femur head between the 4 groups （5.70 ＋/-3.27%,36.90 ＋/-9.53%,70.30 ＋/-13.63%,2.80 ＋/-2.57%,F =136.004,P =0.000）.There was no statistical difference in the apoptosis rate of femur head between group A and group D （P =0.209）.The apoptosis rate was higher in group B compared with group A （P =0.000） and was higher in group C compared with group B （P =0.000）.There was statistical difference in the results of qualitative detection of femu

关 键 词：股骨头坏死 糖皮质激素类 细胞凋亡 信号传导 转录激活因子类 

分 类 号：R681.8[医药卫生—骨科学]