激素性股骨头坏死大鼠C-反应蛋白水平及藻酸双酯钠干预后的骨重建效应

C-reactive protein variation in rats with steroid-induced avascular necrosis of the femoral head and interventional action of propylene glycol alginate sodium sulfate

目的:观察激素性股骨头坏死发生时C-反应蛋白水平的变化及藻酸双酯钠的干预作用。方法:实验于2006-03/11在吉林大学基础医学院病理教研室实验室完成。①50只健康Wistar大鼠随机分成5组,正常对照组、激素模型组、藻酸双酯钠组、阿仑膦酸钠+乐力组、藻酸双酯钠+阿仑膦酸钠+乐力组,每组各10只。②给药:除正常组外,所有动物按24.5mg/kg予醋酸泼尼松龙臀肌注射,1次/周。藻酸双酯钠组予藻酸双酯钠50mg/d灌服。阿仑膦酸钠组予阿仑膦酸钠2.5mg/d和乐力50mg/d灌服。藻酸双酯钠+阿仑膦酸钠+乐力组予藻酸双酯钠50mg/d、阿仑膦酸钠2.5mg/d和乐力50mg/d灌服。所有动物间断强迫立位4h/d,青霉素钠5万u/周肌注预防感染。于实验第2,3,4,5,6周末,每组选取动物2只,抽取2mL血液用免疫比浊法检测C-反应蛋白,取股骨头进行组织形态学观察。结果:①各组C-反应蛋白水平的变化:实验开始第2周,除正常对照组外,各组C-反应蛋白水平明显增高,与正常对照组比较均差异显著。第3周开始激素模型组与阿仑膦酸钠+乐力组逐渐增高,波动在15～20mg/L之间,与其他各组差异显著;藻酸双酯钠组和藻酸双酯钠+阿仑膦酸钠+乐力组逐渐下降至正常。②各组大鼠股骨头组织形态学观察结果:正常对照组:骨小梁结构清晰、粗大、排列规则,脂肪细胞少见,偶见空骨陷窝,髓腔内红细胞丰富。激素模型组:第4周骨小梁明显稀疏、变细,甚至断裂,结构模糊,髓腔内脂肪细胞增多、肥大,红细胞数量减少,空骨陷窝数量逐渐增多,第6周更显著。藻酸双酯钠组和阿仑膦酸钠+乐力组介于正常对照组和激素模型组之间。藻酸双酯钠+阿仑膦酸钠+乐力组接近于正常对照组。结论:C-反应蛋白在激素性股骨头坏死中起着重要作用,它可以作为激素性股骨头坏死早期预测的指标,藻酸双酯钠对C-反应蛋白水平有干预作用。

AIM： To investigate the C-reactive protein （CRP） variation in rats with stetroid-induced avascular necrosis of femoral head and the intervention action of propylene glycol alginate sodium sulfate （PSS）. METHODS： The experiment was conducted in the pathological teaching room of Basic Medical College of Jilin University from March to November 2006.①Fifty healthY Wister rats ware randomly divided into five groups with 10 rats in each group： blank control group, glucocorticosteroid model group, PSS group, alendronate sodium （AS） and complex amino acids chelated calcium capsule （CAC） group, PSS and AS and CAC group. ②Administration： Except the blank control group, all rats ware given gluteus injection of 24.5 mg/kg prednisolone acetate, once a week. PSS group were drenched 50 mg daily PSS; AS plus CAC group was treated with 2.5 mg daily alendronate sodium and 50 mg daily complex amino acids chelated calcium capsule; PSS plus AS and CAC group was given 50 mg daily propylene glycol alginate sodium sulfate, 2.5 mg daily alendronate sodium and 50 mg daily complex amino acids chelated calcium capsule. All animals ware forced at intervals to stand for 4 hours everyday, and 50 000 u benzylpenicillin sodium was injected to prevent infection. At the end of 2, 3, 4, 5, 6 weeks, 2 rats in every group ware selected and draw-off 2 mL blood to detect CRP variation with immunoturbidimetry methods; and the femoral head was harvested for histomorphological observation. RESULTS： ①CRP level variation： At the end of 2^rd week, except for the blank control group, the CRP level of all groups increased remarkably and the differences were not significant among those groups, but significant compared with the blank control group. From the 3^rd week, the levels of the glucocorticosteroid model group and AS and CAC group increased gradually and fluctuated between 15 and 20 mg/L, which had significant differences when compared with other groups; however, PSS group and PSS＋AS＋CAC group ware decreased gradually until to the common level. Histomorphological observation of femoral head： In the blank control group, the construction of the trabeculae of femoral head was clear and thick and arranged regularly; adipocyte and numbers of empty bone lacunae was few; red cells in the bone marrow ware abundant. In the glucocorticosteroid model group, the trabeculae of bone at the fourth week became thinner and rarefaction and less solid, even fragmentation, and the fatty cells in the bone marrow cavity became more and large, but the red cells became less and less, the number of empty bone lacunae increased remarkably, especially to the sixth week. The PSS and AS＋CAC groups were between the control group and model group. The PSS＋AS＋CAC group was similar to the blank control group. CONCLUSION： CRP plays an important role in steroid-induced avascular necrosis of femoral head; it could serve as a predictor to assess the early steroid-induced avascular necrosis of femoral head. Propylene glycol alginate sodium sulfate could interfere CRP level.