一氧化氮对激素性股骨头缺血坏死治疗的生化研究  

A Biochemical Study of Nitric Oxide on the Treatment of Steroid-induced Necrosis of Femoral Head

作　　者：刘金辉[1] 聂喜增[2] 周吉怀[1] 李锋[1] 

机构地区：[1]石家庄市第三医院骨科,050011 [2]白求恩国际和平医院

出　　处：《骨与关节损伤杂志》2003年第5期313-315,共3页The Journal of Bone and Joint Injury

摘　　要：目的　分析一氧化氮 (NO)在前凝血状况下诱导实验性激素性股骨头缺血坏死过程中的作用。方法　 36只成年新西兰兔随机分为三组 ,A组 (正常对照组 ) 12只 ;B组 (疾病模型组 ) 12只 ,间隔三周于兔耳缘静脉注射马血清 ,共 2次 ,每次10ml/kg。于第二次注射后 2周 ,腹腔连续 3d注射甲基强的松龙 ,共 3次 ,每天 1次 ,每次 4 0mg/kg,建立激素性股骨头缺血坏死模型 ;C组 (治疗组 ) 12只 ,模型诱导方式同B组 ,模型复制成功后 ,将硝酸甘油作为一氧化氮外源供体 ,采用介入疗法 ,通过微泵导管直接注入双侧股骨头供血动脉内 ,持续泵注药液治疗 2周。三组动物均于实验完成后行心内穿刺抽取全血标本 ,测定血小板α颗粒膜蛋白 (GMP - 14 0 ) ,氧化型低密度脂蛋白 (OX -LDL) ,NO的血浆含量 ,而后处死 ,切取双侧股骨头行HE染色 ,光镜下观察病理改变 ,统计空骨陷窝率和软骨下区血管数 ,进行组间t检验。结果　A、C组血浆OX -LDL和GMP - 14 0水平明显低于B组 ,而血浆NO水平明显高于B组。C组空骨陷窝率及软骨下区血管数虽未完全达到A组正常水平 ,但较B组有明显改变。结论　NO生成减少导致的OX -LDL合成增多是引发激素性股骨头缺血坏死过程中系统血管内凝血的重要环节 ,以一氧化氮供体作为药物 。Objective To analyse the role of nitric oxide (NO) in steroid induced necrosis of the femoral head for investigating the mechanism of steroid induced necrosis of the femoral head.Methods Thirty six rabbits were divided randomly into 3 groups.Group A were composed of twelve control animals.Group B were composed of twelve animals that were treated with a combination of sterile horse serum and methylpoednisolone.They received 10 ml/kg of sterile horse serum intravenously twice at three weeks intervals.Two weeks after the second injection of sterile horse serum,the 40 mg/kg/day of methylpoednisolone acetate were injected intraperitoneally for three conseoutive day.Group C were composed of twelve animals too.After given the same practice as Group B,they received the two weeks interventional therapy of minipump by nitroglycerin as exterior nitric oxide donor.Blood samples were collected from heart puncture immediately after experiment completely.OX LDL,GMP 140 and NO were measured.The histopathological changes of femoral head of all rabbits were observed after the end point of experiment.Results The result showed:In group A and B,the OX LDL and GMP 140 levels in plasma were more lower than that in group B,however,the No level in plasma was much more than that in group B.in group C,the number of vacant bony lacunae in femoral head and blood vessel in subchondral areas showed significant improvement,though still not reaching the normal levels of the group A.Conclusion The decrease of NO results in increase of OX LDL,which might play an important role in the systemic intravascular coagulation pathogenesis of steroid induced femoral head avascular necrosis.Interventional therapy by nitric oxide can improve the blood supply of steroid induced femoral head necrosis which is an effective method in the treatment of steroid induced femoral head necrosis.

关 键 词：一氧化氮 激素 股骨头缺血坏死 治疗 生化研究’ 

分 类 号：R681.8[医药卫生—骨科学]