激素性股骨头坏死患者骨组织中骨代谢相关因子的表达

Research on expression levels of bone metabolism related protein in osseous tissue of glucocorticoidinduced necrosis of femoral head

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ARCOⅣ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q PCR检测股骨头标本骨组织中Runt相关转录因子2(Run X2)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);q PCR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、Run X2、BGP表达水平过低相关。

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 Run X2 was detected by q PCR. 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 Run X2 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,Run X2 and BGP in the osseous tissue of femoral head.