复方丹参缓释系统植入治疗股骨头缺血性坏死的实验研究

Experimental study on implantation of calcium phosphate cement/danshen drug delivery system for avascular necrosis of the femoral head

[目的]探讨磷酸钙骨水泥(calcium phosphate cement,CPC)复方丹参缓释系统局部植入治疗股骨头缺血性坏死的机理。[方法]健康新西兰大白兔30只,制作股骨头坏死模型后,分为CPC组、CPC/丹参缓释系统组及对照组。于治疗后1、2、3和4周取标本,行HE染色和血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)免疫组化染色,记录空骨陷窝率、VEGF阳性血管率、VEGF阳性成骨细胞率、VEGF阳性软骨细胞率。[结果]CPC/丹参缓释组空骨陷窝率较对照组及单纯CPC组明显降低,VEGF阳性血管率、VEGF阳性成骨细胞率、VEGF阳性软骨细胞率较其他2组明显增加(P<0.01,P<0.05)。[结论]CPC丹参缓释系统通过中药的局部缓释,可促进VEGF等细胞因子的分泌刺激血管内皮的增殖、分化,促进血管的生长和修复,从而改善、重建股骨头局部微循环,促进骨坏死修复。

[ Objective] To explore the role of implantation calcium phosphate cement （calcium phosphate cement） / Danshen drug delivery system for avascular necrosis of the femoral head. [ Method] The New Zealand white rabbits were randomly divided into CPC/Danshen group, CPC group and the control groups after the model of avascular necrosis of the femoral head have been copied. The animals were killed at 1, 2, 3, 4 weeks respectively after operation, histological examination and VEGF immunohistochemistry stain were done to determine the change in different groups. [ Result ] Compared to CPC group and the control group, the ratio of empty osteocytes lacuna dramatically decreased in CPC/Danshen group, and ratio of positive VEGF reaction of vessel, osteoblast, chondroblast significantly increased （P 〈0. 01, P 〈0. 05）. [ Conclusion] With local application of traditional Chinese medicine, this improved procedure can promote the express of VEGF and local angiogenesis, which will benefit reconstruction of the local microcirculation and repair of the necrotic femoral head.