CAJ | 학술논문

目的：观察激素性股骨头坏死患者骨组织中相关因子的表达情况，探讨激素性股骨头坏死的可能作用机制。方法2013年10月至2014年2月，收集在广州中医药大学第一附属医院三骨科14例需行全髋关节置换术（ THA）的病例（其中7例为激素性股骨头坏死ARCO Ⅳ期的患者入实验组，7例为股骨颈骨折的患者入对照组）。采用免疫组织化学检测股骨头标本骨组织中转化生长因子－β1（TGF－β1）、基质金属蛋白酶－2（MMP－2）、骨钙素（BGP）表达水平，采用qPCR检测股骨头标本骨组织中Runt相关转录因子2（RunX2）信号的表达水平。结果实验组患者骨组织病理检查均显示有股骨头坏死，对照组均未发现股骨头坏死征象。免疫组织化学检测实验组股骨头骨组织中TGF－β1、MMP－2、BGP的表达结果较对照组低，差异均具有统计学意义（ P＜0．05）；qPCR检测实验组股骨头骨组织中Run X2信号的表达结果较对照组低，差异均具有统计学意义（ P＜0．05）。结论激素性股骨头坏死的机制可能与股骨头骨组织中的 TGF－β1、MMP－2、RunX2、BGP表达水平过低相关。
목적：관찰격소성고골두배사환자골조직중상관인자적표체정황，탐토격소성고골두배사적가능작용궤제。방법2013년10월지2014년2월，수집재엄주중의약대학제일부속의원삼골과14례수행전관관절치환술（ THA）적병례（기중7례위격소성고골두배사ARCO Ⅳ기적환자입실험조，7례위고골경골절적환자입대조조）。채용면역조직화학검측고골두표본골조직중전화생장인자－β1（TGF－β1）、기질금속단백매－2（MMP－2）、골개소（BGP）표체수평，채용qPCR검측고골두표본골조직중Runt상관전록인자2（RunX2）신호적표체수평。결과실험조환자골조직병리검사균현시유고골두배사，대조조균미발현고골두배사정상。면역조직화학검측실험조고골두골조직중TGF－β1、MMP－2、BGP적표체결과교대조조저，차이균구유통계학의의（ P＜0．05）；qPCR검측실험조고골두골조직중Run X2신호적표체결과교대조조저，차이균구유통계학의의（ P＜0．05）。결론격소성고골두배사적궤제가능여고골두골조직중적 TGF－β1、MMP－2、RunX2、BGP표체수평과저상관。
Objective To observe the expression of bone metabolism ralated protein in osseous tissue of the femoral head from the patients who have glucocorticoid-induced necrosis of femoral head and explore the mechanism.Methods From October 2013 to February 2014, in the third department of orthopedics of First Affiliated Hospital of Guangzhou University of Chinese Medicine , 14 cases underwent total hip replacement ( seven cases of glucocorticoid-induced necrosis of femoral head were in the experimental group and the other seven cases of femoral neck fracture were in the control group ) .The pathological examinations were performed on the 14 femoral head specimens: the expressions of TGF-β1, MMP-2, and bone gla protein ( BGP ) in the osseous tissue of femoral head were determined by immunohistochemistry , and the expression level of RunX 2 was detected by qPCR . Results The pathological results of the experimental group all showed the characteristics of necrosis of the femoral head , while the control group did not present necrotic changes .The expressions of TGF-β1, MMP-2 and BGP in the experimental group were lower than those in the control group according to the immunohistochemistry . The differences were statistically significant (P<0.05).The expression level of RunX2 in the experimental group was lower than the control group , and the difference was significant (P<0.05).Conclusion The mechanism of glucocorticoid-induced necrosis of femoral head may relate to the excessively low expression levels of TGF-β1, MMP-2, RunX2 and BGP in the osseous tissue of femoral head .