旋转恒定磁场治疗激素性股骨头坏死的效果与病理机制

Effect and Pathologic Mechanism of Rotating Permanent-magnetic Field to Treat Steroid-induced Necrosis of Femoral Head

【目的】探讨旋转恒定磁场(RPMF)治疗激素性股骨头坏死的疗效和病理机理。【方法】制备新西兰兔股骨头坏死动物模型,予旋转恒定磁场(铋铁硼永磁体以8Hz频率旋转、形成其上方20cm直径60cm的半球形磁场、表面强度在0.32～0.60T之间)处理4周和8周(A1、A2组),使用组织切片和X线片以及显微CT观察股骨头内部结构变化,同时监测其血液黏稠度、胆固醇、甘油三酯以及髋关节腔压力等的变化,和相应阳性假处理4周、8周组(B1组\B2组)、空白对照(C组)进行统计学分析和比较。【结果】经旋转恒定磁场(RPMF)处理后,动物模型的股骨头骨小梁形态结构显著改善,尤以显微CT表现明显,髋关节腔压力、血液流变学及血脂检测值改善具有显著统计学意义(P<0.05),与时间因素的交互作用疗效次之(Eta2A>Eta2A*B>Eta2B)。【结论】磁场可以针对股骨头坏死主要环节高脂血症、血液黏稠度增加、关节腔压力增高等发挥调节作用,有效治疗激素性股骨头坏死,尤其是早期病变;显微CT在诊断激素性股骨头坏死方面具有灵敏性和直观的优越性。

[Objective] To study the effect and therapeutic mechanism of rotating permanent-magnetlc field （RPMF） for the steroid-induced necrosis of femoral head. [Methods] New Zealand rabbit model of steroid-induced necrosis of femoral head being established, were .exposed to RPMF for 4 weeks and 8 weeks （A1/A2 group）, then X-ray, micro-CT, and pathological examination were adopted to observed the change of femoral head, blood viscosity, serum cholesterol, triglyceride and pressure in coxa articular cavity were measured and analyzed statistically with that of control group （B1 and B2） and sham group （C）. [Results] After RPMF treatment, the osteogenesis regeneration of necrotic femoral head of rabbit model had improved, especially shown markedly by micro-CT, and blood viscosity, serum cholesterol, triglyceride and pressure in coxa articular cavity had significantly descended compared with that of control group B （P〈 0.05）, the effect of RPMF was better than that of the interaction of time factor （Eta2A〉Eta2A＊B〉Eta2B）. [ Conclusion ] RPMF can regulated the course of femoral head necrosis in various critical-aspects, will be a promising measure of the prevention an treatment of steroid-induced necrosis of femoral head, especially on the early stage; mlcro-CT features diagnostic superiority of substantivity and sensitivity.