CAJ | 학술논문

目的观察晚期乙醇性股骨头坏死(ONFH)坏死区骨组织细胞中相关基因的表达.方法收集在全髋关节置换术中切除的20个股骨头,其中,10例世界骨循环研究学会(ARCO)分期Ⅲ-C、Ⅳ期乙醇性ONFH,作为实验组;10例GardenⅢ、Ⅳ型新鲜股骨颈骨折的股骨头,作为对照组.采用实时定量聚合酶链反应(Real-time PCR)分别测定两组坏死骨组织细胞中骨形态发生蛋白-2(BMP-2)、成骨转录因子-2(Runx-2)、过氧化物酶体增殖子活化受体-γ(PPAR-y)、护骨素(OPG)、破骨细胞分化因子(RANKL) mRNA的表达.结果实验组细胞中BMP-2、Runx-2、PPAR-γ、OPG、RANKL mRNA表达水平均较对照组明显降低,2-△△Ct值分别为0.51 ±0.04、0.46 ±0.09、0.59±0.07、0.31 ±0.04、0.52±0.06,两组间差异均有统计学意义(P＜0.01).结论晚期(ARCOⅢ-C、Ⅳ期)乙醇性ONFH的骨组织坏死区很大,股骨头内残存的骨活性成分和细胞很少,其成骨与成脂基因表达均降低,股骨头已毁损,适于行人工髋关节置换术.
목적 관찰만기을순성고골두배사(ONFH)배사구골조직세포중상관기인적표체.방법 수집재전관관절치환술중절제적20개고골두,기중,10례세계골순배연구학회(ARCO)분기Ⅲ-C、Ⅳ기을순성ONFH,작위실험조;10례GardenⅢ、Ⅳ형신선고골경골절적고골두,작위대조조.채용실시정량취합매련반응(Real-time PCR)분별측정량조배사골조직세포중골형태발생단백-2(BMP-2)、성골전록인자-2(Runx-2)、과양화물매체증식자활화수체-γ(PPAR-y)、호골소(OPG)、파골세포분화인자(RANKL) mRNA적표체.결과 실험조세포중BMP-2、Runx-2、PPAR-γ、OPG、RANKL mRNA표체수평균교대조조명현강저,2-△△Ct치분별위0.51 ±0.04、0.46 ±0.09、0.59±0.07、0.31 ±0.04、0.52±0.06,량조간차이균유통계학의의(P＜0.01).결론 만기(ARCOⅢ-C、Ⅳ기)을순성ONFH적골조직배사구흔대,고골두내잔존적골활성성분화세포흔소,기성골여성지기인표체균강저,고골두이훼손,괄우행인공관관절치환술.
Objective To observe the related gene expression levels in the necrotic tissue of the alcohol-induced osteonecrosis of the femoral head (ONFH) in advanced stage.Methods The 20 femoral heads have been gathered during THA from 10 patients with the alcohol-induced ONFH in advanced stage as the experimental group,and from 10 patients with fracture of femoral neck as the control group.The expression levels of bone morphogenetic protein-2 (BMP-2),Runt-related transcription factor-2 (Runx-2),peroxisome proliferator-activated receptor-γ (PPAR-γ),osteoprotegerin (OPG),receptor activator of NF-κB ligand (RANKL) mRNA in the bone-marrow cells of necrotic tissue of the femoral head of all patients were measured by real-time quantitative polymerase chain reaction(Real-time PCR).Results The expression levels of BMP-2,Runx-2,PPAR-γ,OPG and RANKL mRNA in the experimental group were significantly lower than those in the control group.2-△△Ct values of BMP-2,Runx-2,PPAR-γ,OPG and RANKL in the experimental group were 0.51 ± 0.04,0.46 ± 0.09,0.59 ± 0.07,0.31 ± 0.04 and 0.52 ±0.06,respectively,with the differences being statistically significant between two groups (P ＜ 0.01).Conclusion The very large size of necrotic tissue area was seen in the alcohol-induced ONFH in advanced stage,ARCO Ⅲ-C,Ⅳ.There were few of bone active ingredients and residual surviving bonemarrow cells in the femoral head,and the expression level of osteogenic and adipogenic genes in the cells was very lower.The femoral head has been seriously damaged,which is suitable for the total hip arthroplasty.