辛伐他汀治疗早期激素性股骨头坏死的实验研究

The experiment of simvastatin curing the femoral head necrosis due to corticosteroid in the early stage

目的研究辛伐他汀治疗大鼠早期激素性股骨头坏死的效果。方法将55只大鼠随机分成空白组(K组)15只,实验组40只,向实验组按20mg/kg剂量交替经大鼠双侧臀大肌注射地塞米松磷酸钠,每周1次,制备大鼠早期激素性股骨头缺血坏死模型。造模6周后将成功的30只大鼠随机分成造模组(Z组)和灌胃治疗组(G组),每组15只。G组以辛伐他汀(10mg·kg-1·d-1)灌胃治疗,K、Z组以等剂量的蒸馏水灌胃。灌胃4、8、12周,取股骨,分别进行股骨头骨密度分析及股骨头大体和光镜观察。结果①G组灌胃治疗后各时间相点股骨头骨密度均有不同程度的增高,12周后骨密度水平显著高于Z组,两组比较差异有统计学意义(P<0.01);②G组灌胃治疗后股骨头的形状完整,逐显光滑,色泽逐渐接近正常,光镜下见骨小梁不同程度增粗,结构渐规则,新生毛细血管、骨组织日益明显,髓腔内脂肪细胞大小及分布均匀;③G组灌胃治疗后各时间相点空骨陷窝数均有减少,12周后空骨陷窝率明显低于Z组,两组比较差异有统计学意义(P<0.05)。结论辛伐他汀可能通过多种机制,促进早期激素性股骨头坏死的修复。

Objective To research the effect of simvastatin on curing rats,femoral head necrosis due to corticosteroid in the early stage. Methods A total of 55 rats were randomly divided into normal control group （n=15） and experimental group （n=40）. The experimental group was injected with dexamethasone sodium phosphate （20mg/kg） into gluteus maximus once a week to make rats,steroid-induced femoral head necrosis model in the early stage. At the sixth week, 30 out of 40 rats were e-qually divided into model group and simvastatin therapy group. The therapy group was intragastrically administrated with simvas-tatin （10mg/kg） once a day. Model and control groups were intragastrically administrated with the equal volume of saline. The femoral was obtained at 4, 8, and 12 weeks and the the femoral head was analysed with the bone mineral density and observed with general observation and light microscope. Results ①After 12 weeks of treatment, the bone mineral density in the thera-py group was significantly higher than that in the model group, the difference was statistically significant （P＆lt;0.01）.②Gross ob-servation and light microscopy in therapy group demonstrated that the femoral head was in good shape ,the colour and luster of it was gradually getting normal. The bone trabecula increased thickly in many regions and the structure was nearly regular. A large quantity of newborn bone-tissue and lots of newborn microvessels could been found around the necrosis regions and the shape of marrow cavity showed almost normal appearance. ③After 12 weeks of treatment, the percentage of empty osteocyte lacunae was obviously lower in the therapy group than those in the model group,the difference was statistically significant （P＆lt;0.05）. Con-clusion Simvastatin can effectively restore steroid-induced femoral head necrosis in the early stage by several ways.