髓芯减压联合VEGF与胶原基骨移植材料对兔股骨头缺血坏死的修复作用  

Research on the repair effect of core decompression combined with VEGF and collagen-based bone graft material on avascular necrosis of the femoral head in rabbits

作　　者：吕亚军[1] 任立中[1] 李军[1] 张海静[1] 张志坤[1] LYU Yajun;REN Lizhong;LI Jun;ZHANG Haijing;ZHANG Zhikun(Department of Orthopedics,The First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院骨二科,河北石家庄050031

出　　处：《西部医学》2023年第8期1098-1103,共6页Medical Journal of West China

基　　金：河北省卫计委指导课题(ZD20140210)。

摘　　要：目的 探讨髓芯减压联合血管内皮生长因子(VEGF)与胶原基骨移植材料对兔股骨头缺血坏死的修复作用。方法 对24只SPF级家兔股骨头内注射无水乙醇建立兔股骨头坏死模型,然后将家兔随机分为模型对照组(A组)、髓芯减压+自体松质骨组(B组)、髓芯减压+胶原基骨修复材料组(C组)和髓芯减压+胶原基骨修复材料+VEGF组(D组),每组6只,共治疗12周。通过苏木精伊红(HE)染色观察组织切片形态。采用骨密度分析系统(QCT PRO V6.1)测量家兔股骨头骨密度(BMD)。Western blot检测VEGF、Collagen I、Runt相关转录因子2(RUNX2)、骨钙素(OCN)、Wnt-3a、β-catenin和GSK-3β的蛋白表达。结果 术后12周时,与B、C组比较,D组家兔股骨头骨小梁排列较整齐,骨髓中观察到大量微血管的形成,可见明显成骨,且坏死区基本被修复。与A组相比,B组、C组和D组家兔股骨头空骨陷窝比率均显著降低(P<0.05);D组家兔股骨头空骨陷窝比率小于B组和C组(P<0.05)。与A组相比,B组、C组和D组家兔股骨头的骨密度均显著升高(P<0.05);D组骨密度显著高于B组和C组(P<0.05)。与B组和C组相比,D组VEGF、Collagen I、RUNX2和OCN的蛋白表达水平均显著升高(P<0.05);与B组和C组相比,D组Wnt-3a和β-catenin的蛋白表达水平均显著升高,GSK-3β的蛋白表达水平显著降低(P<0.05)。结论 髓芯减压联合VEGF与胶原基骨移植材料对兔股骨头缺血坏死可有效促进坏死股骨头的修复,提高骨密度及成骨蛋白的表达。Objective To investigate the repair effect of core decompression combined with VEGF and collagen-based bone graft material on avascular necrosis of the femoral head in rabbits.Methods 24 rabbits were injected with absolute ethanol into the femoral heads to establish a rabbit femoral head necrosis model.Then the rabbits were randomly divided into model control group(group A),core decompression+autologous cancellous bone group(group B),core decompression+collagen-based bone repair material group(group C)and core decompression+collagen-based bone repair material+VEGF group(group D).There were 6 animals in each group for a total of 12 weeks of treatment.The morphology of tissue sections was observed by hematoxylin-eosin(HE)staining.Bone mineral density(BMD)was measured using the Bone Density Analysis System(QCT PRO V6.1).The protein expression of vascular endothelial growth factor(VEGF),Collagen I,Runt-related transcription factor 2(RUNX2),osteocalcin(OCN),Wnt-3a,β-catenin and GSK-3βwere detected by Western blot.Results At 12 weeks postoperatively,compared with groups B and C,the trabecular bones of group D were arranged more neatly,a large number of microvessel formation was observed in the bone marrow,obvious osteogenesis was seen,and the necrotic area was basically repaired.Compared with group A(29.23±5.00)%,the ratio of empty bone lacuna in group B(18.52±3.25)%,group C(14.21±2.97)%and group D(9.34±3.82)%was significantly reduced(P<0.05).In addition,the ratio of empty bone lacuna in group D was significantly lower than that in groups B and C(P<0.05).Compared with group A(369.38±25.38)mg/cm 3,the bone density of group B(450.53±21.32)mg/cm 3,group C(510.60±37.51)mg/cm 3 and group D(579.05±36.93)mg/cm 3 significantly increased(P<0.05).In addition,the bone density of group D was significantly higher than that of group B and C(P<0.05).Compared with group B and group C,the protein levels of VEGF,Collagen I,RUNX2 and OCN in group D were significantly higher(P<0.05).Compared with groups B and C,the protein level

关 键 词：股骨头坏死 血管内皮生长因子 髓芯减压 胶原基骨修复材料 骨密度 

分 类 号：R459.9[医药卫生—治疗学]