透明质酸钠联合地塞米松修复鼠膝关节创伤性关节炎:随机对照

Dexamethason with sodium hyaluronate for treatment of traumatic arthritis: a randomized controlled trial

背景:关节腔内注射地塞米松或透明质酸钠可有效缓解创伤性关节炎疼痛,增加关节活动度。目的:观察地塞米松联合透明质酸钠修复鼠膝关节创伤性关节炎的效果。方法:将48只SD大鼠随机分成4组,均切断左膝前交叉韧带并切除内侧半月板,制作膝关节创伤性关节炎模型。缝合伤口3周后,其中3组关节内分别注射地塞米松+透明质酸钠、地塞米松、透明质酸钠,以不注射任何物质的为空白对照组。注射后4,8,12周取骨缺损修复标本行大体观察、正侧位X射线片检测及苏木精-伊红染色病理检测。结果与结论:修复12周时,X射线显示,地塞米松+透明质酸钠组关节间隙无明狭窄,地塞米松组和透明质酸钠组轻度狭窄,空白对照组关节间隙明显狭窄,骨关节炎严重;苏木精-伊红染色显示,地塞米松+透明质酸钠组纤维样软骨组织生长良好,地塞米松组和透明质酸钠组不同程度纤维软骨样细胞增生,空白对照组有少量纤维增生。结果表明地塞米松联合透明质酸钠能促进软骨的修复,保护关节功能。

BACKGROUND：Intra-articular injection of sodium hyaluronate or dexamethasone can relieve pain and increase range of motion after traumatic arthritis. OBJECTIVE：To observe the effect of dexamethasone combined with sodium hyaluronate on traumatic arthritis of rat knees. METHODS：Forty-eight Sprague-Dawley rats were randomly divided into four groups. The anterior ligament of the left knee was resected and the medial meniscus was removed to establish models of traumatic arthritis in al the rats. After 3 weeks, the four groups were respectively injected dexamethasone＋sodium hyaluronate （combined group）, dexamethasone, sodium hyaluronate, and nothing （control group）. After 4, 8, 12 weeks of injection, the samples were obtained for gross observation, anteroposterior and lateral X-ray films and hematoxylin-eosin staining. RESULTS AND CONCLUSION：At 12 weeks after injection, X-ray films showed that there was no stenosis in the combined group, mild stenosis in the dexamethasone and sodium hyaluronate groups, and obvious stenosis in the control group （indicating severe osteoarthritis）;hematoxylin-eosin staining exhibited the fibrous cartilage-like tissue grew wel in the combined group, varying degrees of proliferation of fibrous cartilage-like cells were visible in the dexamethasone and sodium hyaluronate groups, and there was a smal amount of fibrosis in the control group. These findings suggest that the combination of dexamethasone and sodium hyaluronate can improve the cartilage repair and restore the joint function.