激素性股骨头骨坏死发病机制的实验研究  

Experimental Study on the Mechanisms of Steroid-induced Necrosis of Femoral Head

作　　者：刘忠堂[1] 王坤正[2] 池永龙[1] 李幼芬[2] 党晓谦[2] 

机构地区：[1]温州医学院第二附属医院骨科,325027 [2]西安医科大学第二附属医院骨科

出　　处：《中国矫形外科杂志》2001年第12期1191-1194,共4页Orthopedic Journal of China

摘　　要：目的 :通过建立动物实验模型 ,采用血清学、放免、病理组织学、透射电镜等方法 ,探讨PGE2 和TXB2 在激素性股骨头骨坏死中的意义。方法 :选用健康成年中国白兔 40只 ,雌雄不限 ,体重 ( 2 .5± 0 .5 )kg ,随机等分两组。实验组 ,臀部肌注甲基强的松龙琥珀酸钠 ,每次 8ml/kg ,每周 2次。对照组以等量生理盐水替代激素。各组于处理前和处理后 2、4、6、8周 ,测定血脂、血浆前列腺素E2 (PGE2 )和血栓烷素B2 (TXB2 )含量。并于第 4、8、10、周分批处死动物 ,取肝脏和股骨头作常规病理组织学和超微结构观察。结果 :( 1)实验组血浆总胆固醇、甘油三酯、极低密度脂蛋白较对照组增高 ,差异有显著性。 ( 2 )从实验第 4周开始实验组PGE2 较对照组明显增高 ,差异非常显著 (P <0 .0 1)。 ( 3)实验第 4周 ,TXB2 较对照组明显增高 ,经秩和检验差异有显著意义 (P <0 .0 5 )。 ( 4 )实验组股骨头骨组织内早期见髓腔脂肪细胞增多且细胞肥大 ,造血细胞减少 ,周围可见大量炎性细胞。电镜下见核膜破坏 ,染色质碎裂 ,晚期见空泡骨陷窝形成。结论Objective:To study the significance of PGE 2 and TXB 2 on the hormoral ischemic necrosis of femoral head by techniques of serology,radioimmunoassay,pathohistology,and transmission electron microscope on an experimental model,to present a therapeutic basis for prophylaxis and treatment.Methods:40 healthy mature Chinese white rabbits,weight 2.5±0.5kg were selected without sexual restriction and randomly divided into two groups:20 as group B or group of hormone.The serum lipid,prostaglandin E 2(PGE 2) and thromboxane B 2 (TXB 2) were measured before and after the 4 th ,8 th and 10 th week of the experiment.The rabbits were killed by parcel after 4,8 and 10 weeks if experiment,when the liver and femoral head were taken and pathohistology and supra microstructure were observed.Results:The lipid of experiment group rose obviously.The level of PGE 2 rose obviously by the 4 th week,which showed statistical difference between them( P <0.01).The ITP of femoral head of experimental group increased later but significantly in the end of the 10 th week ( P <0.05).The necrosis of femoral head appeared in experimental group,and a great deal of osteocytes had fatty degeneration and necrosis.Under electronic microscope,the osteocytes of femoral head had abnormal increase of lipid drop,lateral movement,degeneration and dark dye of nucleus,and the dissappearance of organelles.Conclusion:The ischemic necrosis of femoral head induced by hormon is caused by the disordered circulation of femoral head led by the combination of many factors.

关 键 词：花生四烯酸 激素性股骨头缺血坏死 发病机制 

分 类 号：R681.8[医药卫生—骨科学]