牙髓干细胞静脉注射与联合髓芯减压治疗兔早期激素型股骨头坏死的对比研究

Comparative Study of Dental Pulp Stem Cells Intravenous Injection and Combined Core Decompression in the Treatment of Early Steroid-Associated Femoral Head Necrosis in Rabbits

目的:研究静脉应用牙髓间充质干细胞对兔早期激素型股骨头坏死的治疗作用,为临床应用提供实验数据支持。方法:将健康成年日本大耳兔47只,随机分为4组。A组(正常对照组)5只,B组(模型组)14只,C组(静脉注射干细胞组)14只,D组(干细胞移植组)14只,对B、C、D三组构建股骨头坏死模型后按组别给予相应治疗。建模12周后,采集X线,Micro-CT、组织切片及免疫组化指标并进行统计学分析。结果:静脉给药组和干细胞移植组在骨体积分数BV/TV、骨小梁厚度Tb.Th、骨小梁数量Tb.N、结构模型指数SMI、骨密度BMD、空泡陷窝率、骨小梁面积比、VEGF与模型组均存在统计学差异(P<0.05)。且干细胞移植组指标优于静脉给药组。结论:静脉注射牙髓干细胞和髓芯减压后隧道内注射牙髓干细胞均对治疗兔激素型股骨头坏死有效,并且干细胞移植的疗效优于静脉注射给药.

Objective:To study the therapeutic effect of intravenous application of dental pulp stem cells on early steroid-associated femoral head necrosis in rabbits,and to provide experimental data support for clinical application.Methods:Forty seven healthy adult Japanese white rabbits were randomly divided into 4 groups.There were 5 rats in group A(normal control group),14 rats in group B(model group),14 rats in group C(intravenous administration group)and 14 rats in group D(stem cell transplantation group).Models of femoral head necrosis were built among group A,B,and C before relative treatment was conducted to every of the three groups.After 12 weeks of modeling,the X-ray,micro CT,tissue sections and immunohistochemical indexes were collected and statistically analyzed.Results:There were significant differences between group C and group D in bone volume fraction(BV/TV),trabecular thickness(Tb.Th),trabecular number(TB.N),structural model index(SMI),bone mineral density(BMD),void lacuna rate,trabecular area ratio and VEGF(P<0.05).The indicators of stem cell transplantation group(group D)were better than those of intravenous administration group(group C).Conclusion:Both intravenous injection of dental pulp stem cells and intratunnel injection of dental pulp stem cells after core decompression are effective in the treatment of steroid induced femoral head necrosis in rabbits,and the effect of stem cell transplantation is better than that of intravenous injection.