骨形态发生蛋白在股骨头缺血性坏死区的表达

Expression of bone morphogenetic protein in avascular necro-sis region of the femoral head

目的:分析骨形态发生蛋白与股骨头缺血性坏死的关系,观察其在缺血性坏死区的表达。方法:实验于2003-01/2004-01在桂林医学院附属医院骨科完成。对20例股骨头缺血性坏死患者的股骨头进行取材,取材点分为A、B、C区。A区:股骨头缺血性坏死区中心;B区:股骨头缺血性坏死区边缘;C区:股骨头正常骨质区。并对标本区域进行组织学检查和免疫组织化学检查。结果:组织学检查A区为无序排列的坏死组织及死骨;B区主要以新生的小血管和部分新生骨为主;C区为排列有序的板层骨。免疫组织化学检查A区骨形态发生蛋白无阳性染色;B区血管内皮细胞骨形态发生蛋白染色阴性,邻近部分成骨细胞及少许软骨细胞出现细胞核黄染的阳性表现;C区正常骨细胞的细胞核骨形态发生蛋白染色基本为阴性。结论:在股骨头缺血性坏死的病理过程中,缺血因素存在及骨形态发生蛋白相对缺乏,导致股骨头逐渐坏死,新骨修复缓慢。

To analyze the association between bone morphogenetic protein （BMP） and avascular necrosis of the femoral head and observe its expression in avascular necrosis region. METHODS： The experiment was conducted at the Department of Orthopedics, Affiliated Hospital of Guilin Medical College from January 2003 to January 2004. Specimen were obtained from A： the center of necrosis; B： the periphery of necrosis; C： the normal district of the femoral head in 20 patients with avascular necrosis of the femoral head. Histological examination and immunohistochemical examination were conducted in specimen region. RESULTS： Necrotic tissues and bone were observed in A district in disorder. In B district, neovascularization and new bone were mainly found. Bone trabecula was observed in C district in order. It showed no BMP positive expression in A district in order. In B distric, negative protein staining of BMP was found and positive staining of BMP in a few osteoblast and chondrocytes. In C district the staining of BMP in the normal osteocytes was negative. CONCLUSION： In the pathological process of avascular necrosis of the femoral head, bone dead and new bone formation is slow, which are due to avascular factors and BMP defect.