CAJ | 학술논문

背景：皮质类固醇激素性骨坏死是造成髋关节功能丧失的主要病因之一。近年研究表明，激素性股骨头坏死可能与激素引起的骨髓间充质干细胞增殖能力有关。 　　目的：检测皮质类固醇性骨坏死患者骨髓间充质干细胞的增殖活性，为建立自体骨髓干细胞移植治疗股骨头坏死的合理性寻求证据。 　　方法：选取皮质类固醇性股骨头坏死病例设为股骨头坏死组，按取材部位不同再分为股骨头坏死股骨头组、股骨头坏死髂骨组，同时选取无股骨头坏死、无激素应用的拟行人工关节置换的股骨颈骨折患者设为对照组。用密度梯度离心法分离各组骨髓间充质干细胞，再经贴壁筛选法筛选，选取第3代细胞进行实验。 　　结果与结论：MTT结果显示，股骨头坏死股骨头组增殖能力明显弱于其他2组，其骨髓间充质干细胞在培养后1-7d为生长滞留期，第8天达到对数生长期，以后进入到平台期，而其他2组较病例组生长曲线明显前移，并且峰值增高。流式细胞仪测定的细胞周期结果显示，股骨头坏死股骨头组中G0/G1细胞比例明显增高，而S+G2/M期细胞比例降低，细胞增殖指数较其他2组降低(P <0.05)，而股骨头坏死髂骨组的细胞增殖活性最强。结果证实，皮质类固醇性骨坏死患者股骨头来源的骨髓间充质干细胞增殖活性较低，髂骨来源的骨髓间充质干细胞活性增殖活性较高。
배경：피질류고순격소성골배사시조성관관절공능상실적주요병인지일。근년연구표명，격소성고골두배사가능여격소인기적골수간충질간세포증식능력유관。 　　목적：검측피질류고순성골배사환자골수간충질간세포적증식활성，위건립자체골수간세포이식치료고골두배사적합이성심구증거。 　　방법：선취피질류고순성고골두배사병례설위고골두배사조，안취재부위불동재분위고골두배사고골두조、고골두배사가골조，동시선취무고골두배사、무격소응용적의행인공관절치환적고골경골절환자설위대조조。용밀도제도리심법분리각조골수간충질간세포，재경첩벽사선법사선，선취제3대세포진행실험。 　　결과여결론：MTT결과현시，고골두배사고골두조증식능력명현약우기타2조，기골수간충질간세포재배양후1-7d위생장체류기，제8천체도대수생장기，이후진입도평태기，이기타2조교병례조생장곡선명현전이，병차봉치증고。류식세포의측정적세포주기결과현시，고골두배사고골두조중G0/G1세포비례명현증고，이S+G2/M기세포비례강저，세포증식지수교기타2조강저(P <0.05)，이고골두배사가골조적세포증식활성최강。결과증실，피질류고순성골배사환자고골두래원적골수간충질간세포증식활성교저，가골래원적골수간충질간세포활성증식활성교고。
BACKGROUND:Corticosteroid-induced osteonecrosis of femoral head is one of the major causes of the loss of hip joint function. More and more studies have shown that corticosteroid-induced osteonecrosis of femoral head may be associated with proliferation ability of bone marrow mesenchymal stem cells. OBJECTIVE:To detect the proliferation and differentiation ability of bone marrow mesenchymal stem cells isolated from patients with steroid-induced osteonecrosis of femoral head, providing rational evidences for treatment of corticosteroid-induced osteonecrosis of femoral head with the transplantation of autologous bone marrow containing bone marrow mesenchymal stem cells into the necrotic area of femoral head. METHODS:Bone marrow mesenchymal stem cells from the femoral heads were col ected from patients with corticosteroid-induced osteonecrosis of femoral head, and new femoral neck fractures without osteonecrosis who were scheduled for total hip arthroplasty. In another group, bone marrow mesenchymal stem cells were col ected from ilium bone marrow of the same steroid-induced osteonecrosis of femoral head patients. The femoral neck fracture was defined as fracture without preceding trauma or in response to minimal trauma. Cases with corticoid treatment were excluded from the femur neck fracture patients. Al bone marrow mesenchymal stem cells were divided three groups:femoral neck fracture group;femoral head group of corticosteroid-induced osteonecrosis of femoral head;ilium group of corticosteroid-induced osteonecrosis of femoral head. The bone marrow mesenchymal stem cells were isolated by enzyme digestion or density gradient centrifugation from bone marrow blood of the three detecting area, and then selected by the adhesive method. Passage 3 bone marrow mesenchymal stem cells were selected for experiments. RESULTS AND CONCLUSION:The results of methyl-thiazolyl-tetrazolium assay indicated that the bone marrow mesenchymal stem cells obtained from the femoral head group showed reduced proliferation ability compared with those obtained from the other two groups. The percentage of bone marrow mesenchymal stem cells was increased at G 0/G 1 , but decreased significantly at S+G 2/M in the femoral head group (P<0.05). The bone marrow mesenchymal stem cells obtained from the ilium group were proliferated best. The decreased proliferation ability of bone marrow mesenchymal stem cells may play a role in the low repair capacity of corticosteroid-induced osteonecrosis of femoral head, and bone marrow mesenchymal stem cells from the ilium of patients with corticosteroid-induced osteonecrosis of femoral head have a better proliferative ability.