雷奈酸锶预防大鼠创伤性股骨头坏死塌陷的尝试与探索

Strontium ranelate for the management of traumatic osteonecrosis of the femoral head in preventing collapse in rats

[目的]探讨雷奈酸锶预防大鼠创伤性股骨头坏死塌陷的疗效。[方法]将45只SD大鼠随机分成A、B、C三组,每组15只。A组为安慰剂组,在建立股骨头坏死模型后给予生理盐水灌胃治疗;B组为雷奈酸锶治疗组,在建立股骨头坏死模型后给予雷奈酸锶灌胃治疗;C组为假手术组,同样给予生理盐水灌胃治疗。术后5周处死大鼠,取术侧股骨分别行X线、Micro-CT及组织学检测。[结果]大体标本观察:B组较A组股骨头变形程度明显减轻。X线显示股骨头高度与宽度的比值A组<B组<C组,A和B组有统计学意义(P<0.05),且B、C组无统计学意义(P>0.05)。Micro-CT分析结果显示B组骨小梁平均数量多于A组,少于C组,三组之间差异均有统计学意义(P<0.05)。B组骨小梁平均厚度低于A组(P<0.05),但和C组相比差异无统计学意义(P>0.05)。B组骨小梁平均间距小于A组,但大于C组,差异均有统计学意义(P<0.05)。B组股骨头骨组织体积、骨表面积、骨矿盐密度均大于A组,小于C组,差异均有统计学意义(P<0.05)。组织学检测显示:B组较A组股骨头骨坏死变形程度明显减轻,破骨细胞明显减少,成骨细胞明显增多。[结论]雷奈酸锶具有抑制破骨细胞同时促进成骨细胞的双重骨代谢调节作用,在大鼠骨坏死动物模型中能明显改善股骨头微观结构,保存股骨头形态,对股骨头坏死塌陷具有一定的预防作用。

[Objective] This study aimed to evaluate the effects of strontium ranelate on prevention of collapse in traumatic osteonecrosis of the femoral head in rats.[Method]Totally 45 SD rats were randomly divided into three groups,and 15 rats in each group. Rats in group A were treated with physiological saline after osteonecrosis was induced surgically,rats in group B were treated with strontium ranelate,and group C were the sham surgery group. All rats were killed 5 weeks after the surgery. X- ray,Micro- CT and histological examination were performed.[Result]Compared with group B,the femoral head deformation extent of group A was significantly lower. Through radiographic assessment,the ratio of the femoral head hight to length of group B was significantly larger than that of group A（ P〈0. 05）,while there was no significant difference considering this ratio of group B and group C. Micro- CT assessment showed that the bone volume（ BV）,bone surface（ BS）,bone mineral density（ BMD）,trabecula number（ Tb. N） and trabecula thickness（ Tb. Th） of group B were all significantly higher than those of group A,while the trabecular separation（ Tb. Sp） of group B was significantly less than that of Group A（ all P〈0. 05）. Compared with group A,reduced osteoclast activity but increased osteoblast activity were observed in group B by histological examination.[Conclusion]Strontium ranelate can improve the microstructure and save the femoral head through reducing osteoclast activity while stimulating new bone formation. It has certain effect on prevention of collapse in traumatic osteonecrosis of the femoral head in rats.