IGF-1在股骨头再造关节软骨化生中的作用

The effect of IGF-1 on reconstruction of femoral head and chondrification of articular cartilage

目的观察分析大转子骨瓣表面骨膜及腱膜等纤维结缔组织向关节软骨转化的规律及胰岛素样生长因子-1(IGF-1)在软骨化生过程中的作用。方法制备液氮冷冻双侧股骨头缺血性坏死(Osteonecrosis of femoral head,ONFH)的动物模型。左侧股骨头造模后即缝合关节囊,右侧股骨头根据分组不同采用不同的处理方式:A组(骨瓣治疗组):带血管蒂大转子骨瓣进行股骨头再造;B组(骨瓣加Ad-IGF-1基因治疗治疗组):带血管蒂大转子骨瓣股骨头再造,关节内注入表达IGF-1的腺病毒载体(Ad-IGF-1);两组动物分别于3,6,12,18,24周每批4只处死,对骨瓣进行大体观察,组织病理学观察,免疫组化检测。结果所有动物左侧冷冻区组织坏死,纤维状物覆盖,碎片样组织修复。组织病理切片及免疫组化证实A组右侧骨瓣区自6周出现透明软骨细胞,B组右侧骨瓣区自3周出现透明软骨细胞,B组较A组修复效果好。结果经统计学处理有统计学意义。结论大转子表面的骨膜及腱膜能够向关节软骨化生,IGF-1对大转子表面的骨膜及腱膜向关节软骨化生有促进作用,为ONFH的外科治疗及生长因子的应用提供基础。

Objective Toanalyzetheeffectsofinsulin-likegrowthfactor-1（IGF-1）onreconstruction of femoral head and chondrification of articular cartilage from the periost and aponeurosis of the greater trochanter bone flap surface. Methods Animal models of bilateral avascular necrosis of femoral head （ONFH） using liquid nitrogen frozen skill were performed. Animals were randomly divided into A and B groups ,with the number of 20 for every group. The joint capsule of left femoral head were sutured after the treatment,however,the right femoral head underwent different approaches. For group A （bone flap treatment group）,femoral head reconstruction were performed using the greater trochanteric bone flap with vessel pedicle,and for group B （bone flap and IGF-1 gene therapy treatment group）,intra-articular injection of Ad-IGF-1 were performed after the femoral head reconstruction by greater trochanteric bone flap. At the 3,6,12,18 and 24 weeks point after treating,4 animals were killed at every time point respectively,for morphologic observation,histopathologic detection of bone flaps. Results Tissue nevrosis appeared at the frozen left femoral head for all animals,accompanied by fiber coverage,and debris-like tissue repair. Histologic detection confirmed that,hyaline cartilage cells appeared in the right bone area at the 6 week point for group A,whereas,hyaline cartilage cells appeared in group B as early as 3 week point,which implied the better repair effects of group B,compared to that of group A. Conclusions The periost and the aponeurosis of greater trochanteric bone flap are capable of chondrometaplasia,which will be prompted by the help of IGF-1. Our work is a beneficial attempt for applying cytokines during the treatment of ONFH.