激素性股骨头坏死血小板和内皮细胞源性膜微粒数量的变化及药物干预实验研究

Effects of steroid on platelet-and endothelial-derived microparticles with/without an intervention agent

目的探讨在糖皮质激素诱发血液高凝、易栓状态导致的股骨头缺血坏死发病过程中,血小板和内皮细胞源性膜微粒(EMPs)的数量的变化,同时在给予干预药物抗骨增生胶囊情况下,观察上述膜微粒的数量变化。方法给健康成年新西兰兔肌注射甲泼尼龙,同时对照组肌注相同剂量的生理盐水,干预组连续给予干预药物,于注射前、注射后第1、3、7、14天和第28天各抽静脉全血,使用流式细胞仪对CD31+/CD42b-和CD31+/CD42b+的膜微粒进行定量测定。结果给予激素肌注后,CD31+/CD42b-和CD31+/CD42b+的膜微粒显著升高(P<0·05),分别在第7天和第14天达峰值,而干预组的膜微粒在激素和干预药物的共同作用下虽有波动,但未出现统计学差异。结论应用大剂量糖皮质激素后,兔体内血小板和内皮细胞源性膜微粒数量显著增加,干预药物能够抑制微粒的产生,或许有助于预防或避免激素诱发股骨头缺血坏死的发生。

Objective To investigate the alterations of platelet- and endothelial-derived microparticles and the changes of coagulation in the steroid-induced avascular osteonecrosis of femoral head with/without an intervention agent. Methods Healthy New Zealand rabbits in intervention group were injected once intramuscularly with methylprednisolone and neveived intervention agent; while the control group were injected once intramuscularly with the same dose of 0. 9% NaCl solution. The blood samples were collected before injection of methylprednisolone and on the 1st day, 3rd day, 7th day, 14th day and 28th day after the injection. The microparticles expressing CD31 ＋/CD42b- and CD31 ＋/CD42b ＋ were measured using flow cytometry. Results The numbers of PMPs and EMPs increased markedly after steroid administration. On the 7th and 14th day, the intervention group was affected by the hormone and the drug simultaneously, but despite the fluctuations of EMPs number , there was no significant difference. Conclusions High-dose glucocorticosteroid increases the level of EMP. The intervention agent appeared to have the efficacy to decrease the EMP level which can be considered as a true target in the pharmacological control of steroid-induced osteonecrosis.