CAJ | 학술논문

目的：探讨降脂抗凝联合作用对兔激素性股骨头坏死（SIONF）骨细胞凋亡影响。方法雌性日本大白兔44只，随机分为3组：生理盐水对照组（CTR组，12只），激素性股骨头坏死组（SIONF组，16只），阿托伐他汀华法林治疗组（AW组，16只）。SIONF组和AW组静脉注射大肠杆菌内毒素（10μg·kg-1）及肌肉注射甲基强的松龙（20 mg·kg-1），建立兔SIONF动物模型。CTR组仅注射等量生理盐水。AW组口服阿托伐他汀（2.5 mg·kg-1·d-1）、华法林（1.0 mg·kg-1·d-1）。实验前及实验后2、4、6周随机抽样2只动物，实验终点（第8周）处理所有动物，采静脉血测定血清总胆固醇（Tch）、低密度脂蛋白（LDL）、血浆凝血酶原时间（PT）、组织型纤溶血酶原激活剂（t-PA），摄双侧髋关节X片，处死动物行股骨头骨细胞凋亡检测。结果从实验第6周开始到实验终点，AW组与CTR组Tch、LDL稍增高，但组间比较无统计学差异（P>0.05），而SIONF组Tch、LDL显著高于CTR组及AW组（P<0.05）；从实验第4周开始，AW组PT及t-PA较CTR组和SIONF组显著延长（P<0.05），SIONF组与CTR组比较PT、t-PA缩短（P<0.05）；实验终点CTR组股骨头X线摄片正常，而SIONF组股骨头表面粗糙，软骨面塌陷，发生率为44%，AW组股骨头有类似SIONF组改变，但显著减轻，发生率为25%。实验第4周开始AW组骨细胞凋亡发生率（AI）开始升高持续到实验终点高达39，较CTR组AI（23）增高（P<0.05），但显著低于SIONF组（66）（P<0.05）。结论降脂抗凝联合应用能显著降低兔SIONF骨细胞凋亡发生，可能与改善高脂高凝状态有关。
목적：탐토강지항응연합작용대토격소성고골두배사（SIONF）골세포조망영향。방법자성일본대백토44지，수궤분위3조：생리염수대조조（CTR조，12지），격소성고골두배사조（SIONF조，16지），아탁벌타정화법림치료조（AW조，16지）。SIONF조화AW조정맥주사대장간균내독소（10μg·kg-1）급기육주사갑기강적송룡（20 mg·kg-1），건립토SIONF동물모형。CTR조부주사등량생리염수。AW조구복아탁벌타정（2.5 mg·kg-1·d-1）、화법림（1.0 mg·kg-1·d-1）。실험전급실험후2、4、6주수궤추양2지동물，실험종점（제8주）처리소유동물，채정맥혈측정혈청총담고순（Tch）、저밀도지단백（LDL）、혈장응혈매원시간（PT）、조직형섬용혈매원격활제（t-PA），섭쌍측관관절X편，처사동물행고골두골세포조망검측。결과종실험제6주개시도실험종점，AW조여CTR조Tch、LDL초증고，단조간비교무통계학차이（P>0.05），이SIONF조Tch、LDL현저고우CTR조급AW조（P<0.05）；종실험제4주개시，AW조PT급t-PA교CTR조화SIONF조현저연장（P<0.05），SIONF조여CTR조비교PT、t-PA축단（P<0.05）；실험종점CTR조고골두X선섭편정상，이SIONF조고골두표면조조，연골면탑함，발생솔위44%，AW조고골두유유사SIONF조개변，단현저감경，발생솔위25%。실험제4주개시AW조골세포조망발생솔（AI）개시승고지속도실험종점고체39，교CTR조AI（23）증고（P<0.05），단현저저우SIONF조（66）（P<0.05）。결론강지항응연합응용능현저강저토SIONF골세포조망발생，가능여개선고지고응상태유관。
Objective To investigate the combined effects of lipid lowering and anti-coagulant on the femoral bone cell apoptosis in rabbit with ste-roid-induced osteonecrosis. Methods A total of 44 female Japanese white rabbits were randomly divided into three groups:normal saline group (CTR group,12 rabbits),steroid-induced osteonecrois of femoral group(SIONF group,16 rabbits),and atorvastatin warfarin treated group(AW group,16 rabbits). Intravenous injection of endotoxin of E.coli(10μg·kg-1)and intramuscular injection of methylprednisolone(20 mg·kg-1)were used to establish the SIONF rabbit model in SIONF group and AW group. CTR group was only administrated with saline. AW group was given atorv-astatin 2.5 mg·kg-1·d-1 and warfarin 1.0 mg·kg-1·d-1 by oral. Random sampling of two animals before the experiment two,four,six weeks after the experiment,and at the end of experiment(the 8th week),the venous blood was collected for testing serum total cholesterol(Tch),low density lipo-protein(LDL),prothrombin time(PT),tissue-type plasminogen activation time(t-PA),and taken bilateral hip X-rays. Then,all animals were scarified,and the femoral head bone cell apoptosis was determined. Results From the sixth week to the end of the experiment,Tch and LDL were slightly increased in CTR group and AW group,but no significant difference was found between the two groups. Tch and LDL were significantly in-creased in SIONF group than CTR group and AW group(P<0.05). From the beginning of fourth week,the PT and t-PA was significantly prolonged in AW group,compared to CTR group and SIONF group(P<0.05),and conversely the PT and t-PA was shortened in SIONF group compared to CTR group(P<0.05).At the end of experiment,the X-rays showed that the structure of femoral head in CTR group was normal,but the femoral head surface in SIONF group was rough and cartilage collapse with an incidence of 44%.In AW group,the femoral head surface was slightly rough and trabecular fuzzy but significantly reduced as compared with SIONF group,and the incidence was 25%. From the beginning of fourth week,the bone cell AI in AW group began to increase till end of the experiment(peaked at 39),which was significantly higher than CTR group(23)(P<0.05),but significantly lower than SIONF group(66)(P<0.05). Conclusion The combined use of lipid-lowering and anti-coagulant can signifi-cantly reduce the occurrence of SIONF bone cell apoptosis in rabbit,and the mechanism may be concerned with the improved high fat and high coag-ulation status.