骨髓基质干细胞移植在激素性股骨头坏死治疗中的作用机制研究

The mechanism of bone marrow stromal cell transplantation in the treatment of steroid induced avascular necrosis of the femoral head

目的研究骨髓基质干细胞移植在激素性股骨头坏死治疗中的作用机制。方法选取2012年2月至2014年2月收治的45例激素性股骨头坏死患者为研究对象,随机数字法将其分为两组。观察组患者给予骨髓基质干细胞移植治疗,对照组患者则行常规处理,对两组治疗效果及肿瘤坏死因子α(TNF-α)水平进行比较。结果观察组患者与对照组空骨陷窝率(20.38±3.55比34.01±3.85)、骨髓坏死面积比(9.19±2.85比19.42±4.57)及骨小梁体积比(38.01±3.54比28.58±4.15)比较,观察组更优,两组比较差异有统计学意义(P<0.05)。观察组患者TNF-α明显低于对照组(1.84±0.27 ng/ml比8.46±1.15 ng/ml),两组比较差异有统计学意义(P<0.05)。结论骨髓基质干细胞移植治疗方式可能是通过降低机体血清TNF-α水平达到修复激素性股骨头坏死的目的。

Objective To study the mechanism of action of bone marrow stromal cell transplantation in the treatment of steroid induced avascular necrosis of the femoral head. Methods Forty - five cases of necrosis of femoral head treated from February 2012 to February 2014 were divided into two groups randomly,patients in the observation group were treated with bone marrow stromal cell transplantation therapy,patients in the control group only received conventional treatment. The therapeutic effects and the level of TNF - α were compared between two groups. Re-sults In the observation group,empty bone lacuna rate,bone marrow necrosis area ratio and trabecular bone volume fraction were significantly higher than the control group（20. 38 ± 3. 55 vs. 34. 01 ± 3. 85,9. 19 ± 2. 85 vs. 19. 42 ± 4. 57 and 38. 01 ± 3. 54 vs. 28. 58 ± 4. 15,respective-ly）,there were significant differences between two groups（all P ﹤ 0. 05）. The level of TNF - α in observation group was lower than control group （1. 84 ± 0. 27 ng/ ml vs. 8. 46 ± 1. 15 ng/ ml,P ﹤ 0. 05）. Conclusion The bone marrow stromal cell transplantation may be the way to decrease serum TNF - α level in order to repair steroid induced necrosis of femoral head.