髓芯减压联合富血小板血浆对兔激素性股骨头坏死的疗效及对金属蛋白酶/ 基质金属蛋白酶组织抑制剂系统的影响
作者:
作者单位:

(海南医学院第一附属医院关节创伤外科,海口 570102)

中图分类号:

R-33

基金项目:

海南省自然科学基金资助项目(814357)


Effect of platelet rich plasma combined with core decompression on the repair of steroid⁃induced avascular necrosis of the femoral head and the MMP / TIMP in rabbits
Author:
Affiliation:

(Department of Joint Trauma Surgery,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,China)

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    摘要:

    目的 探讨髓芯减压联合富血小板血浆(platelet?rich plasma, PRP)对激素性股骨头坏死模型兔的疗效及对其组织基质金属蛋白酶/ 基质金属蛋白酶组织抑制剂( matrix metalloproteinase/ tissue inhibitor of metalloproteinase,MMP/ TIMP)的影响?方法 将42 只实验兔随机分为单纯减压组?联合组和对照三组各14 只,对单纯减压组及联合组建立双侧激素性股骨头(steroid induced femoral head,SANFH)坏死模型并对联合组制备PRP,造模方式:静脉注射10 μg/ kg 大肠杆菌内毒素(lipopolysaccharide,LPS) 2 次,注射间隔为24 h,在第2 次注射LPS后,臀肌注射醋酸泼尼松龙20 mg/ kg,注射3 次,每次注射间隔为24 h;而对照组则同期仅在模型兔臀肌位置注入与醋酸泼尼松龙等量生理盐水?SANFH 动物模型修复方法:减压组单纯接收髓芯减压,联合组接收髓芯减压联合PRP 移植,对照组不予处置?减压组?联合组于术后2?6?10 周拍摄双侧髋关节X 线片,并进行Lane?Sandhu X 线评分,计算新生骨面积百分比?于第10 周拍片完成后抽取三组模型兔静脉血,然后同时处死三组模型兔,取出双侧股骨头,右侧股骨头骨组织检测MMP?2?MMP?9?TIMP?1?TIMP?2 的mRNA 表达水平,左侧股骨头统一观察病理学变化?结果 术后减压组MMP?2 和MMP?9 均显著高于联合组和对照组,而TIMP?1 和TIMP?2 则低于联合组和对照组,差异有显著性(P < 0.05);而减压组的IL?6 和骨陷窝空缺率也显著高于联合组和对照组,同时联合组上述两项指标也高于对照组(P < 0.05); X 线评分方面,术后6 周和10 周,联合组均高于减压组,差异有显著性(P <0.05);而新生骨面积百分比上,术后2 周?6 周?10 周联合组均高于减压组,差异有显著性(P < 0.05)?减压组骨头骨组织切片HE 染色可见大量不连续的骨碎片及骨髓坏死,骨小梁有断裂征象;联合组仅轻度炎性细胞浸润,但已可见成熟骨小梁及骨髓组织?结论 髓芯减压联合PRP 在治疗SANFH 模型兔中能够对MMP/ TIMP 起到积极的正性作用,能有效促进组织修复,其机制值得更深入的研究?

    Abstract:

    Objective To observe the effect of platelet rich plasma (PRP)combined with core decompression on the steroid?induced avascular necrosis of the femoral head (SANFH) and on MMP/ TIM in rabbits. Methods < /b> A total of 42 New Zealand white rabbits were used in this study, and were randomly divided into 3 groups (decompression, combination and control groups, each n =14). The rabbit model of SANFH was established by i. m. injecting prednisolone acetate in the decompression group and combination group. The improved Landesberg method was used to make the platelet rich plasma. The decompression group received core decompression treatment while the combination group received PRP combined with core decompression for bone repair. X?ray photography of the hip joint of the two groups were taken at 2, 6 and 10 weeks after the surgery, and the Lane?Sandhu X?ray scores and new bone area ratio were compared. Venous blood samples of the 3 groups were collected and the bilateral femoral heads were taken for further examination. The left femoral heads were used for histopathological observation and the right ones were used to determine the expression of the mRNA of MMP?2,MMP?9, TIMP?1, and TIMP?2. Results The levels of MMP?2 and MMP?9 in the decompression group were higher than that in the combination group and control group after surgery. The levels of TIMP?1 and TIMP?2 in the decompression group were significantly lower than the combination group and control group (P < 0.05). The IL?6 level and the rate of empty bone lacunae in the decompression group were significantly higher than the combination group and control group (P < 0.05), and that of the combination group was higher than the control group (P < 0. 05). The combination group had a better joint imaging and histopathological evaluation than the decompression group after surgery. Conclusions Our findings demonstrate that PRP combined with core decompression can exert a positive effect on the MMP/ TIMP and bone tissue repair in the treatment of steroid?induced avascular necrosis of the femoral head in rabbits.

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于鹏,纪志华,贾丙申,周立义,付昆.髓芯减压联合富血小板血浆对兔激素性股骨头坏死的疗效及对金属蛋白酶/ 基质金属蛋白酶组织抑制剂系统的影响[J].中国比较医学杂志,2018,28(2):53~58.

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  • 收稿日期:2017-01-12
  • 在线发布日期: 2018-03-14
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