倍他米松关节腔注射对胶原诱导关节炎大鼠骨及软骨代谢的影响  

Effect of articular injection of betamethasone on bone and cartilage metabolism in rats with collageninduced arthritis

作　　者：黄志祥[1,2] 王敏[3] 邓伟明[1] 郭欣[1] 李天旺[1,2] Huang Zhixiang;Wang Min;Deng Weiming;Guo Xin;Li Tianwang(Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou 510317, China)

机构地区：[1]广东省第二人民医院,广州510317 [2]中山大学附属第三医院,广州510630 [3]中山市人民医院,中山528403

出　　处：《新医学》2019年第2期105-109,共5页Journal of New Medicine

基　　金：广东省医学科研基金(2015517)

摘　　要：目的探讨倍他米松关节腔注射对胶原诱导关节炎(CIA)大鼠病情活动性、骨及软骨代谢的影响。方法 24只CIA大鼠随机分为倍他米松单次注射组(Ⅰ组)、多次注射组(Ⅱ组)及空白对照组(Ⅲ组),给予为期4周、每周1次的右踝关节注射。将加强免疫后1周定义为基线期,每次注射后1周即下次操作前为随访1、2、3及4。采用关节炎指数(AI)评价大鼠右踝关节及全身病情,检测血清CRP、核因子-κB受体活化因子配体(RANKL)、骨保护素、Ⅱ型胶原C端肽(CTX-Ⅱ)及软骨寡聚基质蛋白(COMP)水平,行右踝关节软骨病理学检查。结果Ⅰ组大鼠在随访1到随访4的局部及全身AI均低于基线期(P均<0.005),其中随访1最低。Ⅱ组大鼠局部及全身AI进行性下降(P均<0.005)。Ⅲ组大鼠局部及全身AI在各随访间比较差异均无统计学意义(P均> 0.05)。在随访1,Ⅰ组及Ⅱ组右踝AI比较差异无统计学意义(P> 0.017),且均低于Ⅲ组(P均<0.017)。从随访2到随访4,各组间比较差异均有统计学意义(P均<0.017),其中Ⅱ组<Ⅰ组<Ⅲ组。Ⅰ组大鼠血清CRP及RANKL高于Ⅱ组大鼠(P <0.05),低于Ⅲ组大鼠(P <0.05),血清骨保护素趋势与之相反。Ⅰ组大鼠反映软骨情况的CTX-Ⅱ、COMP和右踝关节软骨病理学评分均低于Ⅱ组(P均<0.05),而Ⅱ组上述指标均低于Ⅲ组(P均<0.05)。结论关节腔注射倍他米松在缓解大鼠CIA病情的同时也改善了骨代谢,但对软骨有不良影响。Objective To evaluate the effect of articular injection of betamethasone on the disease activity, bone and cartilage metabolism in rats with collagen-induced arthritis (CIA). Methods Twentyfour CIA rats were randomly divided into the single-injection of betamethasone (groupⅠ), multi-injection of betamethasone (group Ⅱ) and control groups (group Ⅲ). All rats received local injection on the right ankle once per week for 4 consecutive weeks. The baseline period was defined as 1 week after supplementary immunization. Four cycles of follow-ups (1-4) were delivered at 1 week after injection. The severity of the right ankle and systemic inflammation was assessed by arthritis index (AI). The serum levels of C-reactive protein (CRP), receptor activator for nuclear factor-κ B ligand (RANKL), osteoprotegerin (OPG), C-telopeptide of type Ⅱ collagen (CTX-Ⅱ) and cartilage oligomeric matrix protein (COMP) were quantitatively measured. Cartilage biopsy of the right ankle was performed. Results The local and systemic AIs in group Ⅰ were significantly lower than the baseline level in the four cycles of follow-up with the lowest AI in the first follow-up (all P < 0.005). In group Ⅱ, both the local and systemic AIs were progressively declined (both P < 0.005). The local and systemic AIs did not significantly differ among different follow-ups in group Ⅲ(all P > 0.05). During the first follow-up, the AIs of the right ankle did not significantly differ between groups Ⅰ and Ⅱ(P > 0.017), whereas considerably lower compared with that in group Ⅲ(both P < 0.017). From the second to the fourth follow-ups, the AIs significantly differed among three groups in the sequence of group Ⅱ<Ⅰ<Ⅲ(all P < 0.017). In group Ⅰ, the serum levels of CRP and RANKL were significantly higher than those in group Ⅱ(both P < 0.05), whereas considerably lower compared with those in group Ⅲ(both P < 0.05). The opposite results were obtained in terms of the serum OPG level. In group Ⅰ, the CTX-Ⅱ, COMP and pathological score of t

关 键 词：胶原诱导关节炎 倍他米松 关节腔注射 骨 软骨 

分 类 号：R684.3[医药卫生—骨科学]