辛伐他汀预防激素诱导性兔股骨头坏死的疗效分析

Therapeutic efficacy analysis of simvastatin in the prevention of hormone-induced femoral head necrosis in rabbits

【目的】探讨辛伐他汀预防激素诱导性兔股骨头坏死的疗效。【方法】将健康清洁级家兔30只随机分为两组,分别为对照组和预防组。采用马血清耳缘静脉注射加肌注地塞米松的方法造模,预防组在注射激素的同时给动物灌服降脂药物辛伐他汀7.5 mg·(kg·d)-1,对照组灌服同等剂量的自制熟面粉丸。期间定期行MRI检查,比较两组样本股骨头出现坏死的时间及坏死情况。第16周采用光镜观察股骨头内骨小梁的形状,每只家兔取3张间断切片计算空骨陷窝比率。采用ELISA法检测血清胆固醇、甘油三酯及血清骨钙素的含量。【结果】干预第16周后,预防组血清胆固醇和甘油三酯含量均较对照组降低(t=56.445、30.717,P<0.01),预防组血清骨钙素含量较对照组升高(Z=4.667,P<0.01);对照组软骨下骨小梁中骨细胞结构消失,可见大片空骨陷窝,空骨陷窝百分比为(33.27±7.47)%,软骨下骨髓腔可见大片骨髓坏死,预防组骨小梁中偶见小片空骨陷窝,空骨陷窝百分比为(19.00±5.30)%,较对照组明显降低(t=56.445,P<0.01),髓腔中仅可见少量小片状骨髓坏死。【结论】辛伐他汀能有效降低血清胆固醇、甘油三酯含量,同时可使血清骨钙素水平明显升高,改善脂代谢及骨代谢,促进骨形成,对糖皮质激素诱导的骨坏死产生抑制作用,对家兔激素性股骨头坏死有预防作用。

【Objective】To explore the therapeutic efficacy of simvastatin in preventing steroid-induced osteonecrosis of femoral head in rabbits.【Methods】Thirty healthy clean rabbits were randomly divided into two groups:control group and prevention group.The model was established by intravenous injection of horse serum and dexamethasone via ear margin.The rabbits in the prevention group were given simvastatin 7.5 mg·(kg·d)-1,while the rabbits in the control group were given the same amount of self-made cooked flour pills.During the period,MRI examination was performed regularly to compare the time and situation of necrosis of femoral head in both groups.At the 16th week,the shape of trabecular bone in the femoral head was observed by light microscope,and 3 pieces of interposition sections were taken from each rabbit to calculate the ratio of empty bone lacuna.The levels of serum cholesterol,triglyceride and osteocalcin were detected by ELISA.【Results】After 16 weeks of intervention,the serum levels of cholesterol and triglyceride in the prevention group were lower than those in the control group,and the differences were statistically significant(t=56.445,30.717,all P<0.01),and the serum osteocalcin content in the prevention group was higher than that in the control group,and the difference was statistically significant(z=4.667,P<0.01).In the control group,the structure of osteoblasts in the subchondral trabecular bone disappeared,and large empty bone lacunae were found with the percentage of empty bone lacunae(33.27±7.47)%,and large bone marrow necrosis was found in the subchondral bone marrow cavity.In the prevention group,small empty bone lacunae were occasionally found with the percentage of empty bone lacunae(19.00±5.30)%,which was significantly lower than that in the control group(t=56.445,P<0.01),and only a small amount of small pieces of marrow necrosis were found in the medullary cavity.【Conclusion】Simvastatin can effectively reduce serum cholesterol and triglyceride,significantly increase serum osteocalcin,improve lipid metabolism and bone metabolism,promote bone formation,inhibit glucocorticoidinduced osteonecrosis,and prevent steroid-induced osteonecrosis of femoral head in rabbits.