MR T2 mapping成像评估止痛健骨方治疗膝骨性关节炎关节软骨损伤疗效的实验研究

Evaluation of efficacy of Zhitong-Jiangu recipes in treatment of cartilage injury in osteoarthritis using MR T2mapping:An experimental study

目的探讨MR T2mapping成像评价止痛健骨方治疗骨性关节炎软骨损伤疗效的价值。方法采用木瓜蛋白酶关节腔注射法制作新西兰大白兔膝骨关节炎模型,根据治疗方法不同将48只新西兰大白兔随机分为正常对照组、模型对照组、盐酸氨基葡萄糖治疗组、止痛健骨方治疗组。各组治疗4周后行膝关节MR T2mapping成像并对关节软骨基质金属蛋白酶1(MMP-1)含量进行免疫组化分析。比较各组间关节软骨T2值及关节软骨MMP-1含量的差异,并分析不同干预方法、关节软骨MMP-1含量与关节软骨T2值的相关性。结果模型对照组关节软骨T2值高于其他3组(P均<0.01),其他3组间关节软骨T2值差异无统计学意义。盐酸氨基葡萄糖治疗模型组、止痛健骨方治疗模型组间关节软骨MMP-1含量差异无统计学意义,但2组关节软骨的MMP-1含量低于模型对照组(P均<0.05)、高于正常对照组(P均<0.05)。关节软骨MMP-1含量与T2值间为非线性关系,随着前者的升高,后者先缓慢上升再快速上升(P<0.05)。结论 MR T2mapping成像有助于评价止痛健骨方治疗模型兔骨关节炎软骨损伤的疗效,关节软骨MMP-1含量与T2值间可能为非线性关系。

Objective To explore the value of MR T2 mapping imaging in evaluation of the effection of Zhitong-Jiangu recipes in treatment of cartilage injury in osteoarthritis.Methods The models of osteoarthritis in the knee of New Zealand white rabbits were made with intra-articular injection of papain.Totally 48 New Zealand white rabbits were randomly divided into normal control group,model control group,glucosamine hydrochloride treatment group and Zhitong-Jiangu recipes treatment group.MR T2 mapping was performed on the knee and the content of MMP-1 in articular cartilage was analyzed with immunohistochemistry 4 weeks after treatment.The differences of T2 value and MMP-1 content of articular cartilage among the four groups were compared.The correlation among the different intervention methods,MMP-1 content of articular cartilage and the T2 value of articular cartilage were analyzed.Results T2 value of articular cartilage in the model control group was significantly higher than that in the other three groups（all P〈0.01）,and there was no significant difference of T2 value among the other three groups.The MMP-1 content of articular cartilage in glucosamine hydrochloride treatment group and Zhitong-Jiangu recipes treatment group was lower than that in model control group（both P〈0.05）,and was higher than that in normal control group（both P〈0.05）.There was no significant difference between the two groups.The relationship between MMP-1 content and T2 value of articular cartilage was nonlinear.With the increase of MMP-1 content,T2 value first increased slowly and then increased rapidly（P〈0.05）.Conclusion MR T2 mapping imaging is helpful to evaluating the efficacy of Zhitong-Jiangu recipes in treatment of cartilage injury in osteoarthritis in rabbit models.The relationship between MMP-1 content and T2 value of articular cartilage may be nonlinear.