不同分子质量玻璃酸钠注射骨关节炎兔关节液内相关因子的变化  

Changes in related factors in synovial fluid of osteoarthritis rabbits after treatment with different molecular weights of sodium hyaluronate injection

作　　者：马志刚[1] 郭立平[1] 张建宁[1] 李永刚[1] Ma Zhigang;Guo Liping;Zhang Jianning;Li Yonggang(First Department of Orthopedics,Qinghai Red Cross Hospital,Xining 810000,Qinghai Province,China)

机构地区：[1]青海红十字医院骨一科

出　　处：《中国组织工程研究》2020年第5期694-698,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:临床研究显示,不同分子质量玻璃酸钠治疗骨关节炎的疗效存在一定差异。目的:观察不同分子质量玻璃酸钠注射后,骨关节炎兔关节液内白细胞介素1β、肿瘤坏死因子α、基质金属蛋白酶3的变化。方法:将40只大耳白兔(购自青海省实验动物中心)随机分为正常组、模型组、大分子组、小分子组,每组10只:对照组不做任何处理;其余3组在右膝关节腔注入木瓜蛋白酶建立骨关节炎模型,造模成功7d后,大分子组、小分子组右膝关节腔内分别注射(1.5-2.5)×10~6Da、(0.8-1.5)×10~6Da的玻璃酸钠注射液0.3mL,模型组注射等量生理盐水,1次/周,注射5周。末次注射7d时,进行右膝关节腔MRI检测、软骨组织苏木精-伊红染色、关节冲洗液炎性因子质量浓度与蛋白聚糖、骨胶原基因表达检测。实验获得青海红十字医院伦理委员会批准,批准号:201802065。结果与结论:(1)MRI检测:模型组存在关节积液,软骨表面不完整;大分子组软骨表面粗糙且软骨层变薄,但无关节积液;小分子组软骨表面明显粗糙且轻度变薄,但无关节积液;(2)苏木精-伊红染色:模型组、大分子组、小分子组均可见明显的软骨损伤,但大分子组、小分子组损伤程度轻于模型组,其中小分子组损伤程度最轻;(3)炎性因子检测:与对照组比较,模型组白细胞介素1β、肿瘤坏死因子α、基质金属蛋白酶3水平升高(P<0.05);与模型组比较,大分子组、小分子组白细胞介素1β、肿瘤坏死因子α、基质金属蛋白酶3水平降低(P<0.05);小分子组中白细胞介素1β、基质金属蛋白酶3水平低于大分子组(P<0.05),两组肿瘤坏死因子α水平比较差异无显著性意义(P>0.05);(4)基因检测:模型组蛋白聚糖、骨胶原基因表达低于对照组、大分子组、小分子组(P<0.05),大分子组蛋白聚糖、骨胶原基因表达低于小分子组(P<0.05);(5)结果表明:与大分子质量玻璃酸钠比较,小分子质BACKGROUND:Clinical studies have shown that sodium hyaluronate at different molecular weights exhibits therapeutic effects on osteoarthritis.OBJECTIVE:To investigate the changes in interleukin-1 beta,tumor necrosis factor-alpha,and matrix metalloproteinase-3 in synovial fluid of osteoarthritis rabbits after treatment with different molecular weights of sodium hyaluronate injection.METHODS:Forty rabbits(purchased from Qinghai Experimental Animal Center,China) were randomly divided into normal,model,macromolecule,and small molecule groups,with 10 rabbits in each group.The control group did not undergo any treatment.Rabbits in the remaining three groups were injected with papain via the right knee joint cavity to establish rabbit models of osteoarthritis.At 7 days after successful modeling,the right knee joint cavity of rabbits in the macromolecule and small molecule groups were injected with 0.3 mL of(1,5-2.5)×10~6 Da and(0.8-1.5)×10~6 Da sodium hyaluronate injection.Rabbits in the model group were injected with equal amounts of physiological saline,once a week,for 5 successive weeks.At 7 days after the last injection,the right knee joint cavity was examined by MRI,cartilage tissue was stained with hematoxylin-eosin,the level of inflammatory factors in the washing fluid was determined,and proteoglycan and collagen gene expression was detected.This study was approved by the Medical Ethics Committee of Qinghai Red Cross Hospital,China(No.201802065).RESULTS AND CONCLUSION:MR imaging:There were joint effusion and incomplete cartilage surface in the model group.In the macromolecule group,cartilage surface was rough and cartilage layer became thinner compared with the model group.Hematoxyin-eosin staining:Obvious cartilage injury was observed in the model,macromolecule,and small molecule groups,but the injury in the macromolecule,and small molecule groups was milder than that in the model group.The injury in the small molecular group was milder than that in the macromolecule group.Measurement of inflammatory factors:Co

关 键 词：玻璃酸钠 不同分子质量 骨关节炎 白细胞介素1β 肿瘤坏死因子α 基质金属蛋白酶3 关节腔 软骨组织 

分 类 号：R453[医药卫生—治疗学] R459.9[医药卫生—临床医学]