创伤性股骨头坏死中骨细胞凋亡初探

Apoptosis of osteocytes in traumatic femoral head necrosis: A pilot study

[目的]初步探索骨细胞凋亡与创伤性股骨头坏死的关系。[方法]采用光镜观察(HE)、Hoechest33258荧光染色及Bcl2蛋白免疫组化染色对股骨颈骨折和创伤性股骨头坏死患者共30例(分为早、中、晚期组)和10例正常对照的股骨头标本进行组织学观察、骨细胞凋亡和Bcl2蛋白检测。[结果]与对照组相比,30例标本中均可见不同程度的空骨陷窝化。其中,早期组骨细胞凋亡活性强于其它组,中期标本的骨细胞的凋亡活性降低、Bcl2表达增强,而晚期标本几乎不能检测到骨细胞凋亡和Bcl2表达,差异均有显著性意义(P<0.05)。[结论]骨细胞凋亡参与了创伤性股骨头坏死的早期发病过程,适当的干预可能是改善患者预后的关键。

[ Objective] To study the relationship between osteocyte apoptosis and traumatic femoral head necrosis. [ Method] HE, Hoechest 33258 fludrescence staining and immunohistochemistry of Bcl-2 protein were used to illustrate the osteocyte apoptosis in femoral neck specimens from 10 cases of normal control and 30 cases of femoral head fractures and traumatic femoral head necroses, which were divided into early, middle and advanced stages. [ Result] In comparison with the control group, various degrees of empty osteocyte lacunae appeared in all 30 samples from the experimental group. The osteocyte apoptosis activity in the early stage group was higher than that of the other groups, osteocyte apoptosis activity declined but Bcl-2 expression increased in the middle stage group, and in the advanced stage group, both of those activities were hardly detected. There were significant differences among all groups （ P〈0.05 ）. [ Conclusion ] Osteoeyte apoptosis might involve in the initial process of traumatic femoral head necrosis, prompt interventions could be the key to improve the prognosis of patients.