CAJ | 학술논문

背景：临床上对于股骨头坏死病理机制尚不完全知晓，大剂量使用糖皮质激素容易引起股骨头坏死。 　　目的：观察骨髓间充质干细胞联合茶黄素在大鼠激素性股骨头坏死中的临床治疗效果。 　　方法：体外分离培养大鼠骨髓间充质干细胞，将其复合在明胶海绵上。实验分4组，骨髓间充质干细胞联合茶黄素组采用液氮冷冻法建立激素性股骨头坏死鼠模型，并移植复合了骨髓间充质干细胞的明胶海绵，每天进行250 mg茶黄素灌服，设模型对照组，单纯减压组和细胞移植组作对照。 　　结果与结论：造模后4周，4组大鼠股骨头标本外形表现为圆形，关节软骨呈现为苍白色，关节软骨开始出现剥脱现象。造模后4周，模型对照组关节软骨剥脱加重，部分股骨头标本出现塌陷；骨髓间充质干细胞联合茶黄素组股骨头标本呈现出圆形，且为苍白色。造模后8周，模型对照组坏死区增加；单纯减压组出现成骨细胞，且存在纤维性骨痂形成；细胞移植组能够见到少量空骨陷窝，髓腔形态不规则；骨髓间充质干细胞联合茶黄素组出现大量新生骨形成，且髓内脂肪细胞规则。骨髓间充质干细胞联合茶黄素组造模后4，8周空骨陷窝阳性数显著少于其他3组(P <0.05)。结果证实，激素性股骨头坏死采用骨髓间充质干细胞基础上联合茶黄素治疗效果理想。
배경：림상상대우고골두배사병리궤제상불완전지효，대제량사용당피질격소용역인기고골두배사。 　　목적：관찰골수간충질간세포연합다황소재대서격소성고골두배사중적림상치료효과。 　　방법：체외분리배양대서골수간충질간세포，장기복합재명효해면상。실험분4조，골수간충질간세포연합다황소조채용액담냉동법건립격소성고골두배사서모형，병이식복합료골수간충질간세포적명효해면，매천진행250 mg다황소관복，설모형대조조，단순감압조화세포이식조작대조。 　　결과여결론：조모후4주，4조대서고골두표본외형표현위원형，관절연골정현위창백색，관절연골개시출현박탈현상。조모후4주，모형대조조관절연골박탈가중，부분고골두표본출현탑함；골수간충질간세포연합다황소조고골두표본정현출원형，차위창백색。조모후8주，모형대조조배사구증가；단순감압조출현성골세포，차존재섬유성골가형성；세포이식조능구견도소량공골함와，수강형태불규칙；골수간충질간세포연합다황소조출현대량신생골형성，차수내지방세포규칙。골수간충질간세포연합다황소조조모후4，8주공골함와양성수현저소우기타3조(P <0.05)。결과증실，격소성고골두배사채용골수간충질간세포기출상연합다황소치료효과이상。
BACKGROUND:Pathological mechanism of femoral head necrosis is not fuly known, and high-dose corticosteroids are prone to induce femoral head necrosis. OBJECTIVE:To investigate the clinical effect of bone marrow mesenchymal stem cels combined with theaflavin on steroid-induced avascular necrosis of femoral head in rats. METHODS: Rat bone marrow mesenchymal stem cels were isolated and culturedin vitro and compounded onto gelatin sponge, and then, divided into four groups: model group, decompression group, cel transplantation group and combined group. Models of steroid-induced avascular necrosis of femoral head were established using liquid nitrogen method. In the combined group, gelatin sponge carrying bone marrow mesenchymal stem cels was transplanted and 250 mg theaflavin was given daily after modeling. RESULTS AND CONCLUSION:At 4 weeks after modeling, the femoral head samples in the four groups were round with exfoliation of articular cartilage that was pale in color. Then, the exfoliation of articular cartilage was aggravated in the model group, and some specimens appeared to colapse; the femoral head specimens in the combined group were round and pale. Until the 8th week after modeling, bone necrosis was increased in the model group; osteoblasts were found in the decompression group with fibrous calus formation; a few of empty bone lacunae appeared with irregular medulary cavity in the cel transplantation group; a large amount of new bone tissues formed in the combined group, and intramedulary adiocytes were in regular array. At 4 and 8 weeks after modeling, the number of empty bone lacunae was significantly lower in the combined group than the other groups (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels combined with theaflavin is an ideal therapy for steroid-induced avascular necrosis of femoral head.