CAJ | 학술논문

目的：药物99 Tc－MDP治疗对股骨头无菌性坏死（ ANFH）的修复价值研究。方法动物试验分为二个阶段：制作模型阶段和治疗观察阶段。采用肌肉注射地塞米松磷酸钠注射液制作ANFH动物模型，第一阶段设：正常组（ A组）、ANFH模型组（ B组），时间为8周。在病理细胞学、骨密度、骨形态计量检测、四环素双标记试验、核素骨骼显像感兴趣区（ ROI）比值、X线摄片、CT摄片等试验证实ANFH动物模型成立后再进行第二阶段试验。第二阶段设：正常对照组（ C组）、ANFH模型对照组（ D组）、99 Tc－MDP治疗组（ E组）、阿仑膦酸钠治疗组（ F组），并进行99 Tc－MDP和“阿仑膦酸钠”治疗，疗程为16周，行与第一阶段相同的各项检测。并对E组、F组的疗效进行评判。采用SPSS13．0软件统计数据。结果第一阶段结束， A组、B组的病理切片结果显示：A组股骨头无骨组织破坏；而B组表现为：股骨头关节表面软骨破坏，骨小梁稀疏、断裂，空骨陷窝数增多等破坏现象。 B组的骨密度、骨形态计量、四环素双标记试验骨转换值明显降低（P＜0．01），核素“99mTc－MDP”骨骼显像ROI比值、血清BALP、BGP检测结果明显高于（ P＜0．05），X线摄片、CT摄片见B组的股骨头存在稀疏现象，显示ANFH模型成立。经过对E组、F组进行治疗16周后，各项检测指标结果显示，A组、C组与B组、D组试验结果基本相似。 E组、F组均有所改善，以E组骨修复更明显，骨小梁增粗，空骨陷窝消失，各项检测指标接近于C组。结论动物试验显示，99 Tc－MDP治疗动物ANFH疗效明显，不仅具有“阿仑膦酸钠”的双膦酸盐治疗作用，对ANFH治疗后的四环素双标记试验及骨小梁增粗，空骨陷窝消失现象显示，可能存在相对的促进成骨细胞功能和加快损伤骨的骨修复价值。
목적：약물99 Tc－MDP치료대고골두무균성배사（ ANFH）적수복개치연구。방법동물시험분위이개계단：제작모형계단화치료관찰계단。채용기육주사지새미송린산납주사액제작ANFH동물모형，제일계단설：정상조（ A조）、ANFH모형조（ B조），시간위8주。재병리세포학、골밀도、골형태계량검측、사배소쌍표기시험、핵소골격현상감흥취구（ ROI）비치、X선섭편、CT섭편등시험증실ANFH동물모형성립후재진행제이계단시험。제이계단설：정상대조조（ C조）、ANFH모형대조조（ D조）、99 Tc－MDP치료조（ E조）、아륜련산납치료조（ F조），병진행99 Tc－MDP화“아륜련산납”치료，료정위16주，행여제일계단상동적각항검측。병대E조、F조적료효진행평판。채용SPSS13．0연건통계수거。결과제일계단결속， A조、B조적병리절편결과현시：A조고골두무골조직파배；이B조표현위：고골두관절표면연골파배，골소량희소、단렬，공골함와수증다등파배현상。 B조적골밀도、골형태계량、사배소쌍표기시험골전환치명현강저（P＜0．01），핵소“99mTc－MDP”골격현상ROI비치、혈청BALP、BGP검측결과명현고우（ P＜0．05），X선섭편、CT섭편견B조적고골두존재희소현상，현시ANFH모형성립。경과대E조、F조진행치료16주후，각항검측지표결과현시，A조、C조여B조、D조시험결과기본상사。 E조、F조균유소개선，이E조골수복경명현，골소량증조，공골함와소실，각항검측지표접근우C조。결론동물시험현시，99 Tc－MDP치료동물ANFH료효명현，불부구유“아륜련산납”적쌍련산염치료작용，대ANFH치료후적사배소쌍표기시험급골소량증조，공골함와소실현상현시，가능존재상대적촉진성골세포공능화가쾌손상골적골수복개치。
Objective To study the therapeutic value of99 Tc-MDP for bone repairing in aseptic necrosis of the femoral head ( ANFH) .Methods The animal experiment included 2 stages:the establishment of animal model and the treatment observation. ANFH animal model was made by dexamethasone intramuscular injection.Intramuscular injection of dexamethasone was used to establish the ANFH model.In the first stage of 8 weeks, normal group ( Group A) and ANFH model group ( Group B) were set up.The successful animal model was proved by cell pathology, bone morphology, BMD, tetracycline double labeling, bone scintigraphy ROI value, X-ray, and CT.In the second stage of 16 weeks, normal control group ( Group C) , ANFH model control Group ( Group D) ,99 Tc-MDP therapy Group ( Group E) , and alendronate sodium therapy group ( Group F) were set up.The same tests were applied like in stage 1 and the efficacy in Group E and Group F was valued.SPSS13 was used for statistical analysis. Results At the end of stage 1, the pathology showed that no bone tissue was destroyed in Group A, but in Group B the surface soft tissue of the femoral head was destroyed, and bone trabecular breaking and bone lacuna increased. BMD, bone histomorphology, tetracycline double labeling decreased and bone scintigraphy ROI, serum BALP and BGP increased in Group B. ANFH could be seen by X ray and CT in Group B.After 16-week therapy in Group E and Group F, all the test results showed a nearly same results between Group A, C and Group B, D.Improved result showed in Group E and Group F, especially in Group E for bone repairing, bone trabecular increasing, and bone lacuna disappearing.All the results were comparable between Group E and Group C.Conclusion Animal study shows an apparent result of99 Tc-MDP treatment for ANFH.99 Tc-MDP not only has the same function like alendronate sodium showing increased bone trabeculae in tetracycline double labeling test, but also reveals the potential function in promoting osteoblast function and bone tissue repairing indicated by bone lacuna disappearing.