CAJ | 학술논문

目的研究高压氧(HBO)对激素性股骨头坏死(steroid-induced avasculal osteoecrosis of femoral head,SANFH)兔血中白介素19、20(interleukin-19、20,IL19、IL20)的影响.方法健康新西兰白兔78只,随机分为3组:正常对照组(N组)7只,模型组(M组)41只,HBO组30只.M组又分为造模完成组(M0组)10只,造模2周组(M2组)10只,造模4周组(M4组)10只,造模6周组(M6组)11只.HBO组分为2周HBO组(HBO2组)7只,4周HBO组(HBO4组)11只,6周HBO组(HBO6组)12只.采用注射内毒素加甲基强的松龙的方法对模型组及HBO组动物进行造模处理,HBO 组在造模完成后开始HBO处理,1次/d,于造模2、4、6周分别取静脉血检测IL19、IL20的变化,并于取血后处死动物,取双侧股骨头进行组织形态学观察.结果 IL19表达:M0组明显增高,与N组比较差异有统计学意义(P＜0.05);M2、M4组表达较M0组下降,但M2组比HBO2组、M4组比HBO4组的表达高,差异有统计学意义(P＜0.01或P＜0.05).IL20表达:M0组明显增高,与N组比较差异有统计学意义(P＜0.05);M2组的表达较M0组下降,但比HBO2组表达高,差异具有统计学意义(P＜0.05);M4组与HBO4组比较差异无统计学意义(P＞0.05);M6组表达较M4高,HBO6组继续下降,与M6组比较差异有统计学意义(P＜0.05).病理结果:N组股骨头组织形态学正常;M2、M4组可见不同程度的骨髓腔内脂肪细胞变性及坏死,周围有淋巴细胞为主的炎性细胞浸润;M6组表现为骨髓腔纤维化,成骨表现活跃.HBO治疗2周后,股骨头骨细胞核未见明显固缩,骨小梁间骨髓炎症反应明显减轻,骨母细胞及纤维组织增生,治疗4～6周骨母细胞活跃增生,成骨形成.结论 SANFH时兔血中IL19、IL20含量增高,炎症反应是SANFH的病因之一.HBO治疗可抑制IL19、IL20的释放,减轻炎症反应,从而减轻股骨头坏死的程度.
목적 연구고압양(HBO)대격소성고골두배사(steroid-induced avasculal osteoecrosis of femoral head,SANFH)토혈중백개소19、20(interleukin-19、20,IL19、IL20)적영향.방법 건강신서란백토78지,수궤분위3조:정상대조조(N조)7지,모형조(M조)41지,HBO조30지.M조우분위조모완성조(M0조)10지,조모2주조(M2조)10지,조모4주조(M4조)10지,조모6주조(M6조)11지.HBO조분위2주HBO조(HBO2조)7지,4주HBO조(HBO4조)11지,6주HBO조(HBO6조)12지.채용주사내독소가갑기강적송룡적방법대모형조급HBO조동물진행조모처리,HBO 조재조모완성후개시HBO처리,1차/d,우조모2、4、6주분별취정맥혈검측IL19、IL20적변화,병우취혈후처사동물,취쌍측고골두진행조직형태학관찰.결과 IL19표체:M0조명현증고,여N조비교차이유통계학의의(P＜0.05);M2、M4조표체교M0조하강,단M2조비HBO2조、M4조비HBO4조적표체고,차이유통계학의의(P＜0.01혹P＜0.05).IL20표체:M0조명현증고,여N조비교차이유통계학의의(P＜0.05);M2조적표체교M0조하강,단비HBO2조표체고,차이구유통계학의의(P＜0.05);M4조여HBO4조비교차이무통계학의의(P＞0.05);M6조표체교M4고,HBO6조계속하강,여M6조비교차이유통계학의의(P＜0.05).병리결과:N조고골두조직형태학정상;M2、M4조가견불동정도적골수강내지방세포변성급배사,주위유림파세포위주적염성세포침윤;M6조표현위골수강섬유화,성골표현활약.HBO치료2주후,고골두골세포핵미견명현고축,골소량간골수염증반응명현감경,골모세포급섬유조직증생,치료4～6주골모세포활약증생,성골형성.결론 SANFH시토혈중IL19、IL20함량증고,염증반응시SANFH적병인지일.HBO치료가억제IL19、IL20적석방,감경염증반응,종이감경고골두배사적정도.
Objective To investigate effects of HBO on serum IL19 and 1L20 in the animal model of steroid - induced avascular osteonecrosis of femoral head. Methods Seventy-eight healthy New Zealand male rabbits were randomly divided into 8 groups: group N ( the control group),group M2,M4,M6 ( the model groups) and the HBO therapy groups (HBO group 2,HBO group 4,HBO group 6). The animal model of steroid - induced avascular osteonecrosis of femoral head was developed by injections of endotoxin and methylprednisolone. Rabbits in the HBO group 2,HBO group 4,HBO group 6 received HBO therapy 1 hour a day,and the duration of HBO treatment were 2 weeks ( HBO group 2),4 weeks ( HBO group 4) and 6 weeks ( HBO group 6) respectively. Contents of IL19,IL20 in serum were measured and histological changes in the femoral heads were observed as well. Results IL19 in group M0 increased significantly,when it was compared with that of group N(P＜0.05);IL19 in group M2 and M4 were much higher than those in group HBO group 2,HBO group 4 (P ＜0.05,P ＜ 0.01 ). IL20 in group M0 also increased significantly,when compared with that of group N( P ＜0.05 );IL20 in group M2 and M4 were much higher than those in HBO group 2 and HBO group 4 as well( P ＜ 0.01 ). Histological examination of the tissues of the femoral head revealed osteonecrosis and inflammatory cells in M2 and M4 groups,and lighter osteonecrosis together with less inflammatory cells in HBO group 2 and HBO group 4 groups than in M2,M4 groups. Conclusions Contents of IL19,IL20 elevated in the rabbit model of steroid-induced avascular osteonecrosis of femoral head. HBO therapy could inhibit release of IL19 and IL20,alleviate inflammatory response and decrease the extent of osteonecrosis.