透明质酸促进关节软骨缺损修复的实验研究  

Repair effect of haluronic acid on articular cartilage injury:an experimental study

作　　者：刘效仿[1] 张健[1] 侯蕾[1] 黄勋福[1] 吴苑妍 刘礼初[1] 

机构地区：[1]广东省佛山市中医院,528000

出　　处：《中国矫形外科杂志》2015年第24期2271-2276,共6页Orthopedic Journal of China

基　　金：广东省中医药局资助项目(编号:20123016);佛山市院外合作项目(创新载体建设)(编号:2014H10004)

摘　　要：[目的]观察透明质酸对关节软骨损伤修复的作用,并探讨其机制。[方法]经手术建立兔股骨内髁软骨2.5 mm圆形缺损模型,术中于缺损处局部注射、术后每周关节内注射透明质酸0.5 m1。4周后组织学和免疫组织化学分析缺损处软骨修复情况及凋亡细胞发生率;并分析关节液中Ⅱ型胶原、粘多糖和肿瘤坏死因子含量。[结果]透明质酸对关节软骨缺损的修复有明显的促进作用,4周时组织学上可见纤维软骨修复为主,其间散在少量Ⅱ型胶原阳性细胞,部分纤维软骨向透明软骨转化。并且关节液中Ⅱ型胶原和粘多糖增多,TNF-α含量减少,同时软骨和软骨下骨中凋亡细胞发生率降低。[结论]局部注射透明质酸可能通过影响骨髓干细胞增殖与分化,自骨髓和软骨下骨向缺损处诱发新生软骨组织的形成,从而促进软骨损伤的修复。[Objective]To explore the repair effect of haluronic acid（HA） on articular cartilage injury and its mechanism.[Method]We established a rabbit animal model with 2.5mm round cartilage defect at both left and right femoral medial condyles.Each joint received an intra- articular injection of 0.5ml volume of either HA or saline immediately and every week after surgery.The levels of COL- Ⅱ,GAG and TNF- α in joint fluid were analyzedat 4 weeks after the surgery.The cartilage regeneration and the apoptosis incidence were also detected by histology and immunohistochemistry examination respectively.[Result]New cartilage formation was significantly enhanced at HA injected condyles compared to those at control sides.The number of PCNA and COL- Ⅱ positive cells was increased,whereas the number of apoptotic cells was decreased in HA treated group compared to those in control group.In addition,the levels of COL- Ⅱ and GAG were increased,and the level of TNF- α was decreased in HA treated joint fluid.[Conclusion]Local intra- articular injection of HA could enhance cartilage reapir by inducing new cartilage formation from bone marrow and subchondral bone and by stimulating proliferation and differentiation of bone marrow mesenchymal stem cells.

关 键 词：透明质酸 关节软骨 缺损 修复 

分 类 号：R684.3[医药卫生—骨科学]