不同剂量糖皮质激素联合马血清构建激素诱导型股骨头缺血性坏死兔模型

Construction of a rabbit model of steroid-induced osteonecrosis of the femoral head by combining different concentrations of glucocorticoids with horse serum

背景:糖皮质激素的应用已成为中国股骨头坏死的主要因素,建立一个可信的、有效的、低死亡率的激素性股骨头坏死模型,可为更好的探索股骨头坏死的治疗创造条件。目的:通过联合静脉注射不同剂量的马血清和不同剂量的糖皮质激素以建立激素诱导型早期股骨头坏死兔模型。(10方法:将30只健康雄性新西兰白兔随机分为6组,其中4组分别耳缘静脉注射低、高剂量马血清,20 mg/kg)并联合肌肉注射低、高剂量地塞米松(5,10 mg/kg)进行造模,地塞米松组仅用高剂量地塞米松(10 mg/kg)造模,对照组静脉注射不同剂量生理盐水(20,2 mL/kg)。结果与讨论:(1)MRI骨坏死异常信号:高剂量地塞米松联合高剂量马血清组白兔的股骨头在干预后第2周于MRI上首先出现骨坏死异常信号,而除对照组外的其他4组则在干预后第4周出现骨坏死异常信号。干预后第6周,高剂量地塞米松联合高剂量马血清组中80%的兔表现出骨坏死信号,显著高于低剂量地塞米松联合高剂量马血清组(50%)、高剂量地塞米松联合低剂量马血清组(40%)、低剂量地塞米松联合高剂量马血清组(25%)、地塞米松组(20%)(P<0.05);(2)血脂水平:地塞米松联合马血清组血清三酰甘油和总胆固醇水平在进行第1次地塞米松注射后的第3,7,14,30天明显高于对照组(P<0.05);(3)空骨陷窝程度:与对照组相比,高剂量地塞米松联合高剂量马血清组空骨陷窝程度有轻度增加(P<0.05);(4)结果说明,高剂量地塞米松联合高剂量马血清组能够成功建立早期激素性股骨头坏死模型,且更安全有效。

BACKGROUND： Glucocorticoid has been shown to be a major factor of osteonecrosis of the femoral head （ONFH）, so constructing a reliable, effective and low mortality ONFH model will be helpful for searching for a better treatment strategy of ONFH.OBJECTIVE： To construct a rabbit model of early ONFH by intravenous injection of different concentrations of glucocorticoids and horse serum.METHODS： Thirty healthy male New Zealand rabbits were randomly allotted to six groups, followed by given the injection of 10 mg/kg horse serum combined with 5 mg/kg dexamethasone （group A）, 10 mg/kg horse serum combined with 10 mg/kg dexamethasone （group B）, 20 mg/kg horse serum combined with 5 mg/kg dexamethasone （group C）, 20 mg/kg horse serum combined with 10 mg/kg dexamethasone （group D）, 10 mg/kg dexamethasone （group E）, and 2 mL/kg normal saline （control group） via ear veins, respectively.RESULTS AND CONCLUSION： Abnormal MRI signal of the femoral head appeared in the group D at postoperative 2 weeks, while abnormal signal was seen at postoperative 4 weeks in the other groups except the controls. Six weeks postoperatively, 80% rabbits in the group D showed abnormal signals, which were significantly more than those in the groups C （50%）, B （40%）, A （25%）, and E （20%） （P 〈 0.05）. The serum levels of triglyceride and total cholesterol in the groups A, B, C, D were significantly higher than those in the control group at 3, 7, 14 and 30 days after injection （P 〈0.05）. Compared with the control group, the ratio of empty lacuna sigmificantly increased in the group D （P 〈 0.05）.These results indicate that the injection of high concentration of horse serum combined with the high concentration of dexamethasone is successful and safe to make an animal model of early ONFH.