骨髓基质细胞移植治疗股骨头缺血性坏死的实验研究

An experimental study on the treatment of femoral head necrosis with transplantation of marrow stromal cells

目的:探讨骨髓基质细胞移植治疗股骨头坏死的疗效和治疗机制。方法:选用日本大耳白兔60只,随机分为A、B、C和D四组,各组制成激素性股骨头坏死模型。A组为对照组;B组为髓心减压组;C组为直接干细胞移植组;D组为倍增干细胞移植组。B组仅钻孔髓心减压;C组抽取骨髓分离后直接植入坏死的股骨头内;D组抽取骨髓分离、培养倍增后植入股骨头内。各组动物于治疗后8周处死,处死前后分别进行各种指标检测,包括钼靶X线摄影、CT扫描、MR扫描、骨密度测量、常规HE染色切片。结果:股骨头骨髓干细胞移植后8周,骨质密度X线改变不明显,CT和MR明显好转,骨密度增加。病理组织学表现空骨陷窝减少,成骨细胞增多,新骨形成。骨髓基质细胞移植治疗后显示股骨头修复效果明显,而倍增基质细胞移植效果更佳。结论:骨髓基质细胞移植治疗股骨头坏死能加速兔股骨头的修复进程,对股骨头坏死具有较高的治疗价值。

Objective： To investigate the effect and mechanism of transplantation of marrow stromal cells in treating femoral head necrosis. Methods：60 Japanese rabbits were divided into A,B, C and D four groups randomly. After finishing the models of hormone induced necrosis of femoral head, Group A was the control one, Group B was the core drilling decompression, Group C was the direct stem cells transplantation and D was the multiplication stem cells transplantation. The marrow stromal cells of C was extracted only, while D group was extracted and cultured, they were injected into the femoral head. The rabbits were killed at 8 weeks after treatment and changes in various parameters were observed, including X-ray of molybdenum target, CT, Mill, bone density measurement and routine HE staining. Results：8 weeks after the treatment of transplantation of marrow stromal ceils, the X-ray showed little change and typical appearance was observed by CT,MRI and bone density measurement; pathohistologie manifestation showed decrease of empty bone lacuna, increase of osteoblast and new bone formation, and better in multiplication stem cells transplantation group. Conclusion： The treatment of transplantation of marrow stromal cells in femoral head necrosis could accelerate the process of repairing in rabbits and it was a good and valuable treatment in femoral head necrosis.