体外冲击波治疗兔缺血性股骨头坏死过程中血管内皮生长因子的表达

The expression of VEGF in the ischemic necrosis of femoral heads of rabbits after extracorporeal shock wave treatment

目的观察体外冲击波对兔股骨头缺血坏死模型中血管内皮生长因子（VEGF）表达的影响。方法30只新西兰大白兔用甲基强的松龙和脂多糖诱导成股骨头缺血坏死模型，右侧为实验侧接受冲击波治疗，左侧为对照侧，治疗后1、2、4、8、12周取材行苏木素-伊红（HE）染色，VEGF免疫组织化学法检测蛋白表达分布，Westernblot法定量蛋白。结果实验侧软骨下骨组织VEGF的表达较对照组明显增加，在4周时达到高峰，并持续至8周，软骨下骨新生血管和成骨明显。结论体外冲击波治疗能够促进缺血坏死股骨头中新生血管和软骨下骨的形成，VEGF的表达上调可能是其治疗机制。

Objective To observe the effect of the extracorporeal shock wave treatment on vascular endothelial growth factor （VEGF） expression in the necrotic femoral heads of rabbits, and provide theoretical basis for clinical therapy. Methods The methylprednisolone and lipopolysaccharide were applied to induce avascular necrosis of femoral heads in 30 New Zealand rabbits. The right limb （ the study side） received shock wave therapy to the femoral head, and the left limb （the control side） received no shock wave therapy. Biopsies of the femoral heads were performed at the 1 st,2nd ,4th,8th, and 12th week. Immunocytoehemistry and Western blot were used to detect the expression of VEGF. Results The VEGF protein expression levels on the study side was increased to a peak at the 4th week and remained high for 8 weeks after the shock wave treatment, the ingrowth of neovascularization and bone formation were obviously increased at the same time;but on the control side, the VEGF protein always presented low expression, and the bone formation was not evident. Conclusion Extracorporeal shock wave treatment obviously increased the ingrowth of neovascularization and bone formation in the ischemic necrosis of femoral heads of rabbit models. The up-regulation of VEGF may play an important role.