^(99)T_(c-)亚甲基二膦酸盐治疗股骨头坏死动物研究及初步临床应用  

The animal experiment and preliminary study of femur head necrosis treated by ^(99)T_(c-)MDP

作　　者：高克加 李明起 毛诚忠 叶智卫 王建华[1] 梅小刚 赵林妹[1] 

机构地区：[1]上海市黄浦区中心医院核医学科 [2]成都云克药业有限责任公司开发部

出　　处：《中华风湿病学杂志》2004年第2期80-84,i001,共6页Chinese Journal of Rheumatology

摘　　要：目的摇地塞米松诱导兔股骨头坏死后用99Tc鄄亚甲基二膦酸盐治疗并观察疗效,以供初步临床应用于中、晚期股骨头无菌性坏死参考,了解99Tc鄄亚甲基二膦酸盐的治疗价值。方法新西兰白兔33只为动物模型制作材料,其中18只采用注射地塞米松针剂建立股骨头坏死模型,模型建立后分成3组,每组6只;正常对照组、股骨头坏死模型组和股骨头坏死模型99Tc鄄亚甲基二膦酸盐治疗组。99Tc鄄亚甲基二膦酸盐治疗14周后取实验兔股骨头作病理切片,分析99Tc鄄亚甲基二膦酸盐治疗前、后股骨头X线、CT摄片、99mTc鄄MDP骨显像检查结果。临床明确诊断为股骨头无菌性坏死患者67例,分为99Tc鄄亚甲基二膦酸盐治疗组39例和传统保守治疗对照组28例。治疗40周后比较99mTc鄄MDP骨显像、X线摄片、CT检查,同时结合患者的症状作出综合评价。结果采用肌肉注射地塞米松针剂4周的新西兰白兔病理证实股骨头骨质疏松伴坏死模型成立。在99Tc鄄亚甲基二膦酸盐治疗前、后时间内取各组实验兔股骨头X线、摇CT摄片、99mTc鄄MDP骨显像和病理分析比较:正常对照组无变化,股骨头坏死模型组对照组股骨头骨质疏松加重,模型99Tc鄄亚甲基二膦酸盐治疗组的股骨头骨质疏松有较明显的改善。Objective 99Tc-MDP was used to treat aseptic necrosis of femur head of rabbit model induced by DXM.The result was refered to clinical trial in the theatment of middle and late stage aseptic necrosis of femur head in order to understand its value.Methods Thirty-three New Zealand rabbits were chosen as the animal model.Eighteen of them were made into femur head necrosis model by injecting DXM. All animal models were divided into 3 groups with 6 in each:normal group,femur head necrosis group and 99Tc-MDP therapy group.Forteen weeks after therapy,the pathology of femur head was studied. Bone X-ray radiograph,CT and 99mTc-MDP bone scan were tested before and after 99Tc-MDP therapy.Sixty-seven cases of clinical diagnosed aseptic necrosis of femur head patients were separated into 99Tc-MDP therapy group(39 cases) and traditional conservative therapy group(28 cases).After 40 weeks of 99Tc-MDP therapy,99mTc-MDP bone scan,X-ray radipgraph,CT were compared together with clinical symptoms to get a comprehensive evaluation.Results Pathology study proved that the osteoporosis animal model was successfully set up after 4 weeks' injection of DXM.Before and after 99Tc-MDP therapy,the femur heads of animal models were studied and compared by X-ray radiograph,CT,99mTc-MDP bone scan and pathology. The result showed no change in normal control group,but aggravated in femur head necrosis group and improved in 99Tc-MDP therapy group. The clinical result of 99Tc-MDP therapy after 40 weeks showed that 6 cases were improved and 31 were stable and only 2 cases had no effect in 99Tc-MDP therapy group.In conservative therapy group,19 cases showed no effect and only 3 cases were improved.Conclusion 99Tc-MDP is a compound of technetium-99 labeled biphosphonate.Animal experiment showes that it has remarkable effect on osteoporosis.Preliminary clinical study also demonstrates its apparent therapeutic effect on aseptic necrosis of femur head compared with traditional conservative therapy.

关 键 词：^99TC-亚甲基二膦酸盐 治疗 股骨头坏死 动物模型 诊断 

分 类 号：R681.8[医药卫生—骨科学]