Legg-Perthes病关节软骨功能状态改变及其影响

Changes in functional state of articular cartilage and its effects on the process in Legg-Perthes disease

目的 评价Legg Perthes病早期关节软骨功能状态及其对该病发展的影响。 方法 选择健康杂种幼犬 2 0只 ,雌雄不限 ,采用自身对照方法 ,任选一侧髋为实验侧 ,另一侧作为对照。应用TH胶股骨颈内注射法制作Legg Perthes病动物模型 ,于注胶后 8周、1 2周时幼犬分批处死取材 ,观察组织学变化 ,行软骨基质及软骨下骨蛋白多糖 (Proteoglycan ,PG)和碱性磷酸酶 (Al kalinephosphatase ,AKP)测定。 结果 随着实验时间延长 ,关节软骨病变与骨骺坏死病变逐渐加重 ,实验侧关节软骨增厚 ,早期即可观察到软骨细胞分布较稀散 ,软骨深层空缺软骨陷窝明显增多 ,软骨基质及软骨下骨PG含量显著下降 ,软骨下骨AKP活性明显降低。结论 Legg Perthes病时关节软骨功能早期已有明显障碍 ,其与股骨头骨骺坏死病变可相互促进 。

Objective To assess the functional state of articular cartilage at the early stage of Legg Perthes disease and its effects on the development of the disease.Methods Twenty healthy hybrid juvenile dogs were selected without taking gender into account for a self control study. One hip was randomly used as experimental, and the other as control, and the animal model of Legg Perthes disease was set up by injecting TH medical adhesive into the femoral neck. The animals were executed group by group respectively after 8 and 12 weeks. The pathologic changes were observed, and at the same time proteoglycan and alkaline phosphatase analyses at the cartilage matrix and subchondral bone were performed.Results The lesions of the articular cartilage and epiphysis necrosis gradually aggravated as time went by, with the articular cartilage of the experimental hip appearing to be more thickening. At the early stage cartilage cells were found sparsely distributed, and obviously increased void cartilage hollow in deep layer of articular cartilage was observed, and the proteoglycan content which reflects the functional state of articular cartilage and the activity of alkaline phosphatase at the subchondral bone was significantly decreased.Conclusion The function of articular cartilage is handicapped obviously at the early stage of Legg Perthes disease, which can affect and accelerate with the epiphysis necrosis of the femoral head.