CAJ | 학술논문

目的建立糖皮质激素导致的幼兔股骨头缺血坏死模型,观察其生物学特性.方法选用2月龄的新西兰大白兔60只(1.4～1.7 kg),应用随机排列表法,分为:激素注射组(48只),臀肌注射糖皮质激素(7.5 rng/kg)；对照组(12只),臀肌注射等体积的生理盐水(0.3 ml/kg),每周2次,共8周.模型制作完成后,按照日本骨坏死多中心协会提出的标准化股骨头非创伤性坏死诊断标准,根据实验动物是否发病将激素注射组分为:激素注射发病组和激素注射未发病组.于第1次注射后第2、4、6、8周行双髋关节X线正位片、CT扫描检查,分别取双侧股骨头软骨、软骨下骨质行组织病理学、电镜检查.结果按照日本骨坏死多中心协会提出的标准化股骨头非创伤性坏死诊断标准,至第8周末,激素注射组动物存活31只,共7只实验动物被认定为股骨头坏死阳性,本组股骨头缺血性坏死发生率为22.58％(7/31).激素注射组股骨头骨质密度均匀增高,骨纹理消失,骨骺变小,高度下降,髋关节间隙增宽；骨小梁稀疏、变细,部分断裂,排列不规则,骨小梁面积比分别为(34.56±6.14)％、(34.08±6.30)％,较之对照组(53.12±6.10)％均明显减少,差异有统计学意义(P＜0.01)；骨陷窝中骨细胞核固缩、变形、边聚,空骨陷窝增多,而激素注射发病组健侧和激素注射未发病组及对照组双侧股骨头仅有少量骨陷窝空缺,发病组骨陷窝空缺率(24.63±6.83)％明显高于激素注射未发病组(11.03±3.67)％和对照组(10.75±2.16)％,差异有统计学意义(P＜0.01)；其余各组间比较,差异无统计学意义(P＞0.05)；软骨下骨质中骨细胞皱缩,细胞膜不完整,部分细胞质中有脂滴,未见细胞器,核膜不完整,核膜分离,染色质浓缩、边聚.结论单纯臀肌注射糖皮质激素可导致幼兔股骨头缺血坏死的发生.
목적 건립당피질격소도치적유토고골두결혈배사모형,관찰기생물학특성.방법 선용2월령적신서란대백토60지(1.4～1.7 kg),응용수궤배렬표법,분위:격소주사조(48지),둔기주사당피질격소(7.5 rng/kg)；대조조(12지),둔기주사등체적적생리염수(0.3 ml/kg),매주2차,공8주.모형제작완성후,안조일본골배사다중심협회제출적표준화고골두비창상성배사진단표준,근거실험동물시부발병장격소주사조분위:격소주사발병조화격소주사미발병조.우제1차주사후제2、4、6、8주행쌍관관절X선정위편、CT소묘검사,분별취쌍측고골두연골、연골하골질행조직병이학、전경검사.결과 안조일본골배사다중심협회제출적표준화고골두비창상성배사진단표준,지제8주말,격소주사조동물존활31지,공7지실험동물피인정위고골두배사양성,본조고골두결혈성배사발생솔위22.58％(7/31).격소주사조고골두골질밀도균균증고,골문리소실,골후변소,고도하강,관관절간극증관；골소량희소、변세,부분단렬,배렬불규칙,골소량면적비분별위(34.56±6.14)％、(34.08±6.30)％,교지대조조(53.12±6.10)％균명현감소,차이유통계학의의(P＜0.01)；골함와중골세포핵고축、변형、변취,공골함와증다,이격소주사발병조건측화격소주사미발병조급대조조쌍측고골두부유소량골함와공결,발병조골함와공결솔(24.63±6.83)％명현고우격소주사미발병조(11.03±3.67)％화대조조(10.75±2.16)％,차이유통계학의의(P＜0.01)；기여각조간비교,차이무통계학의의(P＞0.05)；연골하골질중골세포추축,세포막불완정,부분세포질중유지적,미견세포기,핵막불완정,핵막분리,염색질농축、변취.결론 단순둔기주사당피질격소가도치유토고골두결혈배사적발생.
Objective To establish a model of avascular necrosis of the femoral head in juvenile rabbits induced by glucocorticoid.Methods Sixty New Zealand albino rabbits (50％ females and 50％ males) aged two months (1.4-1.7 kg) were randomly divided into 2 groups:steroid injection group (SIG) and control group (CG).Prednisolone acetate of 7.5 mg/kg was injected into each rabbit for the SIG (n =48) and normal saline of 0.30ml/kg for the CG (n =12) twice a week for eight weeks.According to the diagnostic criteria for non-traumatic necrosis of femoral head of the Japan association of osteonecrosis multi-center,the SIG was further divided into the disease group (DG) and the non-disease group (NDG).X-ray and CT examination were performed at 2,4,6,and 8 weeks after the first injection.Four rabbits of the SIG and two of the CG were sacrificed after 2,4,6 weeks,and the rest of the rabbits were sacrificed after 8 weeks.The cartilage of the femoral head and the subcartilaginous bone were examined by histopathology and transmission electronic microscope.Results At the end of the 8th week,7 of 31 rabbits developed avascular necrosis of the femoral head in the SIG with the incidence of 22.58％.In the SIG,the bone mineral density of femoral heads was increased evenly and the normal bone texture disappeared.The osteoepiphysis of the femoral heads in the SIG was smaller and the hip clearance was wider than those in the CG.The height of epiphysis in the SIG was also decreased compared to that in the CG.Along with the prolonged glucocorticoid given,symptoms gradually deteriorated.The bone trabeculae became sparser and thinner,and some of them were fractured and irregular in the SIG.At the end of the 8th week,the proportion of bone trabeculae was (34.56 ±6.14) ％ in the DG and (34.08 ± 6.30) ％ in the NDG respectively,with statistical difference compared to that in the CG [(53.12 ± 6.10) ％,P＜0.01].Osteocyte karyopyknosis and transformation were observed in the DG.The incidence of empty lacunae was (24.63 ± 6.83)％ in the DG,which was significantly higher than that in the NDG (11.03 ± 3.67) ％ and that in in the CG (10.75 ± 2.16) ％,(both,P＜0.01).Along with the prolonged GC given,the bone cells shrank,the integrity of cell membranes was destructed,organelles were undetectable,the karyotheca was broken and separated,the chromatin was condensed and marginated,and lipid was found in some osteocytes.Conclusions Simple gluteal injection of GC can lead to avascular necrosis of femoral head in juvenile rabbits.