糖皮质激素受体在Perthes病股骨头软骨及髋关节滑膜组织中的表达及意义

Expression of glucocorticoid receptor in the femoral head cartilage and coxa synovial membrane of Perthes disease

目的探讨糖皮质激素及糖皮质激素受体在Perthes病发病机制中的作用。方法用免疫组织化学方法检测20例Perthes病和10例非Perthes病（3例外伤致髋关节离断及7例尸体标本）的小儿股骨头软骨及髋关节滑膜组织中糖皮质激素受体的表达，并做图像分析。结果糖皮质激素受体在20例Perthes病股骨头软骨中均有表达，对照组10例股骨头软骨中，仅有1例有糖皮质激素受体表达，两者表达率比较，差异有统计学意义（y。=21．607，P〈O．01）；糖皮质激素受体在20例Perthes病髋关节滑膜中均有表达，对照组10例髋关节滑膜中，仅有1例有糖皮质激素受体表达。两者表达率比较，差异有统计学意义（x2=17．919，P〈0．01）。Perthes病组和对照组股骨头软骨的糖皮质激素受体阳性颗粒积分光密度值比较，差异有统计学意义（t=5．893，P〈0．01）；Perthes病组和对照组髋关节滑膜的糖皮质激素受体阳性颗粒积分光密度值比较，差异有统计学意义（t=11．720，P〈0．01）。糖皮质激素受体在Perthes病股骨头软骨与髋关节滑膜中表达呈正相关关系（r=0．787，P〈0．01）。结论糖皮质激素受体可能与Perthes病的发生、发展有关。

Objective To explore the relationship between glucocorticoid receptor（GR） and Perthes disease. Methods Immuno-histochemistry and image analysis were employed to detect the expression of GR in the femoral head cartilage and coxa synovial membrane of 21） specimens of the Perthes disease group and 11） specimens of the control group. There were 3 specimens from hip disar- ticulation and 7 specimens from children corpse specimens in the control group. Results GR were ex- pressed in all 20 eases of Perthes disease femoral head cartilage. In the control group, GR were ex- pressed in only one case . The difference of GR expression of the femoral head cartilage between the Perthes disease group and the control group was significant （x2 = 21.61）7, P〈0. 1）1 ）. GR were ex- pressed in all 20 cases of Perthes disease coxa synovial membrane. In the control group, GR were ex- pressed in 2 cases. The difference of GR expression of the eoxa synovial membrane between the Perthes disease group and the control group was significant （x2= 17. 919, P〈0. 01 ）. GR intergrated optical density（IOD） of the femoral head cartilage in ＊he Perthes disease group was compared with the control group, the difference was significant（t = 5. 893, P〈0. 01 ）. GR IOD of the coxa synovial membrane in the Perthes disease group was compared with control group, the difference was significant （t = 11. 720, P〈0. 01）. Coefficient correlation of GR of the femoral head cartilage to the coxa synovial membrane in Perthes disease was 0. 787（P〈0. 01）, positive. Conclusions GR might play an important role in the growth and development of the pathogenesis of Perthes disease. The linking of GR and Glucocorticoid might promote occurrence and development of Perthes disease.