唑来膦酸钠防治假体周围骨溶解的实验研究

Inhibitory effect of zoledronate sodium on periprosthetic osteolysis induced by polyethylene particles

目的 ：观察唑来膦酸钠对磨损颗粒诱导的大鼠假体周围骨溶解的影响及其作用机制。方法 ：选用30只成年雄性SD大鼠,体重250~300 g,随机分3组,每组10只,分别为空白对照组、模型对照组和唑来磷酸钠组。空白对照组不作任何处理;模型对照组及唑来磷酸钠组行右侧股骨植入聚乙烯颗粒和钛棒制备聚乙烯颗粒诱导假体周围骨溶解大鼠模型,术后唑来膦酸钠组每周皮下注射唑来磷酸钠0.1 mg/kg,连续用药8周后取血、处死并采集右侧股骨标本。测定各组股骨骨密度（BMD）、IL-1β、IL-6、TNF-α及血清TRAP5b、CTX-Ⅰ的含量。结果：与模型对照组比较：唑来膦酸钠组大鼠股骨骨密度增高,IL-1β、IL-6、TNF-α含量均下降;唑来膦酸钠组大鼠血清TRACP5b、CTX-Ⅰ水平降低。结论：唑来膦酸钠组能够有效抑制聚乙烯颗粒诱导的大鼠假体周围骨溶解,可能是通过抑制破骨细胞的活性及IL-1β、IL-6、TNF-α等细胞因子的表达实现,为临床防治人工关节假体周围骨溶解提供理论基础。

Objective：To observe the effect and mechanisim of zoledronate sodium on periprosthetic osteolysis in rat induced by polyethylene particles. Methods：Total 30 adult male SD rats,weighting from 250 to 300 g,were selected and randomly divided into three groups：blank control group,model control group and zoledronate sodium group respectively,10 animals for each group. No treatment was performed in the blank control group. In model control group and zoledronate sodium group,the modle of periprosthetic osteolysis in rats were made by implanting polyethylene particles and titanium rods into their right femurs. After operation,rats in zoledronate sodium group were administered with zoledronate sodium（0.1 mg / kg each week） through subcutaneous injection for 8 weeks,then the blood was obtained and all experimental animals were sacrificed to get the right femur specimens. The femur BMD,IL-1β,IL-6,TNF-α,serum TRACP5 b and CTX-Ⅰwere detected. Results：Compared with the model control group,the femur BMD was increased,while IL-1β,IL-6 and TNF-α were all decreased in zoledronate sodium group; the serum TRACP5 b and CTX- Ⅰlevel were both reduced in zoledronate sodium group. Conclusion：The zoledronate sodium could effectively inhibit periprosthetic osteolysis in rats induced by polyethylene particles,which might be realized by inhibiting the activity of osteoclasts and the expression of IL-1 β,IL-6 and TNF-α. It provides a new method to treat periprosthetic osteolysis of the artificial joint prosthesis.