关节软骨创伤早期关节腔内注射透明质酸对软骨细胞凋亡的影响

Influence of injection of hyaluronate acid into joint cavity of early stage of articular cartilage injury on cartilage cells apoptosis

目的 研究关节软骨创伤（Articular cartilage injury,ACI）后早期行关节腔（Joint cavity,JC）内注射透明质酸（Hyaluronate acid,HA）对软骨细胞（Cartilage cells,CC）凋亡的影响.方法 将2010年3月～2013年3月被确诊为ACI的78例患者,以数字法随机分成观察组与对照组各39例,对照组仅以ACI常规抗感染以及手术等方案治疗,观察组在ACI早期缝合皮肤前行JC内注射HA.对比两组经流式细胞仪以及TUNEL法测定的CC凋亡情况,分析两组CC细胞周期情况.结果 观察组以流式细胞仪测定的CC凋亡率为（3.63±0.46）％,显著低于对照组的（6.87±0.85）％.差异有统计学意义（P＜0.05）.观察组以TUNEL法测定的CC凋亡率为2.98±0.23,显著低于对照组的6.54±0.17.差异有统计学意义（P＜0.05）.观察组G0/G1为82.21±2.02,显著低于对照组的91.32±3.65;S、G2/M、PI分别为8.74±2.65、9.08士1.65和17.81±1.65,均显著高于对照组的3.65±0.27、5.05±0.54和8.71±1.05,差异均有统计学意义（均P＜0.05）.结论 ACI后早期患者行JC内注射HA,可明显减少CC凋亡,促进患者康复,效果较为显著,值得临床推广应用.

Objective To study influence of injection of hyaluronate acid into joint cavity of early stage of articular cartilage injury on cartilage cells apoptosis.Methods 78 patients diagnosed as ACI were randomly divided into the observation group.The control group treated with conventional ACI antibiotics and surgery.The observation group was injected with HA.The CC apoptosis was measured by flow cytometry and TUNEL method.Results The observation group＇s CC apoptosis rate measured by flow cytometry was 3.63±0.46,which was significantly lower than the control group （P〈0.05）.The observation group measured by TUNEL＇s CC apoptosis rate was 2.98±0.23,which was significantly lower than the control group （P〈0.05）.G0/G1 of the observation group was 82.21 ± 2.02,which was significantly lower than the control group.S,G2/M,PI were 8.74±2.65,9.08±1.65,17.81±1.65,which were significantly higher than the control group （P〈0.05）.Conclusion ACI patients in early stage treated with JC injection of HA can significantly reduce the CC apoptosis and promote patients＇ rehabilitation.