骨微血管内皮细胞在股骨头坏死中的作用机制及前景  

Action mechanism and prospect of bone microvascular endothelial cells for treating femoral head necrosis

作　　者：秦宇星 任前贵[2] 李子龙[1] 全嘉星 沈佩锋 孙韬[2] 王浩宇 Qin Yuxing;Ren Qiangui;Li Zilong;Quan Jiaxing;Shen Peifeng;Sun Tao;Wang Haoyu(Department of Hand and Foot Microsurgery,Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China;Department of Emergency,Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010030,Inner Mongolia Autonomous Region,China;Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学第二附属医院手足显微外科,内蒙古自治区呼和浩特市010030 [2]内蒙古医科大学第二附属医院急诊科,内蒙古自治区呼和浩特市010030 [3]内蒙古医科大学,内蒙古自治区呼和浩特市010110

出　　处：《中国组织工程研究》2023年第6期955-961,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:股骨头坏死给患者和社会带来严重的负担,现存在的假说未能完全解释股骨头坏死发生的机制,但骨内微循环系统功能障碍是其病理基础是不容质疑的。鉴于微循环在股骨头坏死中的重要性,近期有报道指出骨微血管内皮细胞损伤在股骨头坏死的发病机制中有着关键作用。目的:分析骨微血管内皮细胞在股骨头坏死中的作用机制,着重探讨基于骨微血管内皮细胞改善微循环促进成骨,从而治疗股骨头坏死的前景。方法:以“股骨头坏死;骨微血管内皮细胞;微循环障碍;骨组织工程技术;microRNAs”为中文关键词,以“Necrosis of femoral head;Bone microvascular endothelial cells;Microcirculation disorder;Bone tissue engineering technology;MicroRNAs”为英文关键词,通过检索CNKI(中国知网)、万方数据库和PubMed数据库得到220篇相关文献,并通过对题目、摘要和部分文献内容的阅读,排除了时效性不强、结论模糊、重复的文献,最后纳入符合标准的63篇文献进行综述。结果与结论:①骨微血管内皮细胞功能障碍导致的血管生成受损、细胞凋亡异常、血栓形成和脂肪栓塞均参与了股骨头缺血性坏死的发生和发展。②中药、骨组织工程技术、基于转染、MicroRNAs等能够通过促进血管生成、抑制细胞凋亡和血管栓塞来预防和治疗股骨头缺血性坏死。③微血管内皮细胞和骨髓间充质干细胞联合移植是治疗股骨头坏死最有希望的策略之一,但具有良好生物相容性的共移植物和支架与培养细胞之间的最佳比例需要进一步研究。④对于基因转染来说,目的基因在宿主细胞的转录调控机制还未完全研究清楚;此外,相关的临床试验较少,治疗效果还有待进一步验证。BACKGROUND:Femoral head necrosis brings a serious burden to patients and the society.The existing hypotheses cannot fully explain the mechanism of the femoral head necrosis.Howeve r,there is no doubt that the dysfunction of bone microcirculation system is its pathological basis.Given the importance of microcirculation during femoral head necrosis,recent studies indicate that bone microvascular endothelial cell injury exe rts a crucial effect on the pathogenesis of femoral head necrosis.OBJECTIVE:To analyze the action mechanism of bone microvascular endothelial cells for treatment of femoral head necrosis,and to focus on the prospect of im proving microcirculation and promoting osteogenesis based on bone microvascular endothelial cells,so as to treat femoral head necrosis.METHODS: "Necrosis of femoral head;bone microvascular endothelial cells;microcirc ulation disorde r;bone tissue engineering technology;microRNAs" were used as Chinese and English keywords.Totally 220 related articles were obtained by searching on CNKI(China National Knowledge Infrastructure),Wanfang database,and PubMed database.Insufficient timeliness,vague conclusions,and repetitive articles were excluded by reading the titles,abstra cts and part of the content.Finally,63 articles that met the inclusion crite ria were included for review.RESULTS AND CONCLUSION:(1) The impaired angiogenesis,abnormal apoptosis,thrombosis and fat embolism caused by the dysfunction of bone microvascular endothelial cells are all involved in the occurrence and development of avascular necrosis of the femoral head.(2) Traditional Chinese medicine,bone tissue engineering technology,transfection-based method,and microRNAs can be employed to prevent and treat avascular necrosis of the femoral head by promoting angiogenesis,suppressing apoptosis and vascular embolism.(3) Combined transplantation of microvascular endothelial cells and bone marrow mesenchymal stem cells is one of the most promising strategies for the treatment of femoral head necrosis,but the optimal ratio

关 键 词：股骨头坏死 骨微血管内皮细胞 微循环障碍 骨组织工程技术 MIRNA 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.1