大鼠模拟臀位体位与髋关节发育不良关系的实验研究  

Risk factors of breech pregnancy for congenital hip dysplasia: an experimental study in rat model

作　　者：任雪[1] 尚聪[1] 王恩波[1] 张立军[1] 刘天婧[1] 李建军[2] 李连永[1] 

机构地区：[1]中国医科大学附属盛京医院小儿骨科,辽宁沈阳110004 [2]中国医科大学附属盛京医院骨科,辽宁沈阳110004

出　　处：《中国矫形外科杂志》2016年第23期2165-2170,共6页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81171675;30700877)

摘　　要：[目的]通过建立臀位体位动物模型模拟宫内臀位状态研究臀位体位对髋关节发育不良的影响。[方法]新生大鼠双后肢捆绑维持髋关节屈曲,膝关节伸展,模仿人类宫内臀位。实验大鼠于生后0、2、4、6、8 d处死,全骨架染色后行后前位骨盆摄像观察髋臼与股骨头的关系并测量软骨髋臼指数(CAI)、中心边缘角(CEA)及髋臼开口直径与深度的比值(D/D)。[结果]随着异常体位维持时间的延长,髋关节发育不良的发生率逐渐增多且严重程度逐渐加重。除0 d组外各实验组与对照组相比CAI明显增大,CEA减小而D/D明显增加。同时发现实验组大鼠坐骨侧方弯曲且髋臼关节软骨变薄。[结论]臀位体位导致髋关节发育不良是一由轻微发育不良至髋关节半脱位直至完全脱位的慢性过程。臀位体位维持时间越长,髋关节发育不良的发生率越高,病理改变越重。[ Objective] To investigate the risk factors of breech pregnancy for congenital hip dysplasia of the hip （DDH） in an experimenta rat model. [ Methods] A total of 185 newborn rats were divided into experiment group （n = 110 ） and the control group （ n = 75 ） . In the experiment group, rats were swaddled to keep the hip flexed and knees extended to simulate hu- man breech presentation. At 0, 2, 4, 6, 8 days after birth, animals were sacrificed and received staining of pecimen, the posteroanterior pelvic picture of the rat skeletons were taken to observe the relationship of the acetabulum and the femoral head. Cartilage acetabular index （CAI）, center -edge angle （CEA） and acetabular diameter/depth ratio （D/D） were meas- ured. [ Results ] The incidence of DDH increased and the severity aggravated with the increase of swaddling time. CAI in the experiment group was significantly larger than that of the control group since day 2. CEA decreased with time going on in the ex- periment group, while D/D increased obviously. Lateral bending of the ischium and thinner articular cartilage were observed in the dysplastic hips. [ Conclusion] The more swaddling time in breech position is, the more incidence and severity of DDH will occur. Breech - related DDH is a chronic process that proceeds from mild dysplasia to subluxation, and finally to frank dislocation.

关 键 词：髋关节发育不良 臀位体位 动物模型 病因学 

分 类 号：R726.8[医药卫生—儿科]