中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2008年
5期
446-449
,共4页
马焕芝%曾炳芳%李晓林%柴益民
馬煥芝%曾炳芳%李曉林%柴益民
마환지%증병방%리효림%시익민
股骨头坏死%糖皮质激素类%高能量冲击波
股骨頭壞死%糖皮質激素類%高能量遲擊波
고골두배사%당피질격소류%고능량충격파
Femoral head necrosis%Glucocorticoids%High energy shock waves
目的 观察高能震波对缺血性坏死股骨头微血管密度(MVD)和组织细胞超微结构的影响,探讨高能震波治疗股骨头缺血性坏死的作用机制. 方法 健康雄性新西兰白兔32只.3.0～4.0kg,平均3.4 kg.联合应用甲泼尼龙和内毒素6周诱发早期股骨头缺血性坏死的动物模型.所有实验兔左后腿作为治疗侧,采用能流密度0.26 mJ/mm2,频率1 Hz,冲击量为2000次的高能震波治疗,右后腿作为对照侧,不予治疗.分别于治疗后4、8、12周对股骨头行微血管墨汁灌注,研究股骨头MVD的变化,制作半薄切片,在透射电镜下分别观察治疗侧和对照侧股骨头组织细胞的超微结构. 结果 高能震波治疗后4～12周,治疗侧股骨头微血管增粗增多,与对照侧相比MVD显著增加(P＜0.05).治疗后8～12周,治疗侧股骨头骨小梁面积百分比显著高于对照侧(P＜0.05).透射电镜下观察可见治疗侧股骨头与对照侧相比成骨细胞和血管内皮细胞数目较多,功能状态活跃. 结论 高能震波治疗能有效促进缺血性坏死股骨头的血管生成,改善成骨细胞和血管内皮细胞的功能状态,加速股骨头坏死的修复.
目的 觀察高能震波對缺血性壞死股骨頭微血管密度(MVD)和組織細胞超微結構的影響,探討高能震波治療股骨頭缺血性壞死的作用機製. 方法 健康雄性新西蘭白兔32隻.3.0～4.0kg,平均3.4 kg.聯閤應用甲潑尼龍和內毒素6週誘髮早期股骨頭缺血性壞死的動物模型.所有實驗兔左後腿作為治療側,採用能流密度0.26 mJ/mm2,頻率1 Hz,遲擊量為2000次的高能震波治療,右後腿作為對照側,不予治療.分彆于治療後4、8、12週對股骨頭行微血管墨汁灌註,研究股骨頭MVD的變化,製作半薄切片,在透射電鏡下分彆觀察治療側和對照側股骨頭組織細胞的超微結構. 結果 高能震波治療後4～12週,治療側股骨頭微血管增粗增多,與對照側相比MVD顯著增加(P＜0.05).治療後8～12週,治療側股骨頭骨小樑麵積百分比顯著高于對照側(P＜0.05).透射電鏡下觀察可見治療側股骨頭與對照側相比成骨細胞和血管內皮細胞數目較多,功能狀態活躍. 結論 高能震波治療能有效促進缺血性壞死股骨頭的血管生成,改善成骨細胞和血管內皮細胞的功能狀態,加速股骨頭壞死的脩複.
목적 관찰고능진파대결혈성배사고골두미혈관밀도(MVD)화조직세포초미결구적영향,탐토고능진파치료고골두결혈성배사적작용궤제. 방법 건강웅성신서란백토32지.3.0～4.0kg,평균3.4 kg.연합응용갑발니룡화내독소6주유발조기고골두결혈성배사적동물모형.소유실험토좌후퇴작위치료측,채용능류밀도0.26 mJ/mm2,빈솔1 Hz,충격량위2000차적고능진파치료,우후퇴작위대조측,불여치료.분별우치료후4、8、12주대고골두행미혈관묵즙관주,연구고골두MVD적변화,제작반박절편,재투사전경하분별관찰치료측화대조측고골두조직세포적초미결구. 결과 고능진파치료후4～12주,치료측고골두미혈관증조증다,여대조측상비MVD현저증가(P＜0.05).치료후8～12주,치료측고골두골소량면적백분비현저고우대조측(P＜0.05).투사전경하관찰가견치료측고골두여대조측상비성골세포화혈관내피세포수목교다,공능상태활약. 결론 고능진파치료능유효촉진결혈성배사고골두적혈관생성,개선성골세포화혈관내피세포적공능상태,가속고골두배사적수복.
Objective To investigate the effect of high energy shock waves on microvessel density and cellular ultrastructure of the necrotic femoral head,and the mechanism of avascular femoral head necrosis treated with high energy shock waves. Methods Thirty.two male adult New Zealand white rabbits,weighing 3.0 to 4.0 kg(average weight,3.4 kg),were used to establish animal models of avascular femoral head necrosis.Bilateral femoral head necroses were induced by methylprednisolone and lipopolysacchafide.The left hind limbs(treatment side)of all rabbits received shock wave treatment to the femoral heads while tlleir fight limbs(control side)received no shock wave treatment.At 4,8 and 12 weeks after the shock wave treatment,vascular infusion with Chinese ink was made to evaluate the morphological changes of blood vessels in the femoral heads and cellular uhrastructure of the femoral head was observed by transmission electron microscope(TEM). Results At 4,8 and 12 weeks after shock wave treatment,microvessel density of the fenoral heads at the treatment side was significantly higher than that at the eontrol side(P=0.001.P=0.001.P=0.000).At 8 and 12 weeks after shock wave treatment,trabecular bone area of the femoral head at the treatment side was also significantly larger than that at the controJ side(P=0.011,P=0.003).TEM showed that the number and the funotion of osteob|asts and vascular endothelia at the treatment side were hiigher than at the control side. Conclusion High energy shock waves may have promoting effect on angiogenesis of necrotic femoral head,improving the function of osteoblasts and vascular endothelia in the femoral head and accelerating repair process of the necrotic femoral head.
