髓芯减压联合胶原基骨修复材料和血管内皮生长因子对兔股骨头坏死血管修复和微循环的影响

Effects of core decompression combined with collagen-based bone repair materials and VEGF on vascular repair and microcirculation in rabbit femoral head necrosis

目的探讨髓芯减压+胶原基骨修复材料和血管内皮生长因子(VEGF)治疗兔股骨头坏死(ONFH)的效果。方法对30只家兔股骨头内注射无水乙醇建立兔ONFH模型。然后将家兔随机分为健康对照组(A组)、模型组(B组)、髓芯减压+自体松质骨组(C组)、髓芯减压+胶原基骨修复材料组(D组)和髓芯减压+胶原基骨修复材料+VEGF组(E组),每组6只。治疗8周,通过苏木精伊红(HE)染色观察组织切片形态。分别测定家兔的全血黏度(高切150 s^(-1)和低切10 s^(-1))、血浆黏度和红细胞压积、血清总胆固醇(TC)和甘油三酯(TG)。通过q RT-PCR检测股骨头组织中von Hippel-Lindau(VHL)、缺氧诱导因子α(HIF-1α)、VEGF和碱性成纤维细胞生长因子(b FGF)的m RNA水平。结果与C、D组比较,E组的全血黏度(高切150 s^(-1)和低切10 s^(-1))、血浆黏度和红细胞压积均显著降低(P<0.05)。与C、D组比较,E组的血清TC和TG均显著降低(P<0.05)。与C、D组比较,E组股骨头组织中VHL m RNA水平显著降低,而HIF-1α、VEGF和b FGF均显著升高(P<0.05)。结论髓芯减压+胶原基骨修复材料+VEGF可有效促进ONFH家兔损伤区域的成骨和血管修复,并且可减轻微循环障碍,其机制与改善脂质代谢、调节VHL/HIF-1α/VEGF信号及bFGF表达有关。

Objective To investigate the efficacy of core decompression plus collagen-based bone repair materialsand vascular endothelial growth factor(VEGF)in the treatment of femoral head necrosis(ONFH)in rabbits.Methods A model ofrabbit ONFH was established by injecting absolute ethanol into the femoral head of 30rabbits.Then the rabbits were randomly divided intoahealthy control group(group A),model group(group B),core decompression plusautologous cancellous bone group(group C),core decompression plus collagen-based bone repair material group(group D),and core decompression plus collagen-based bone repair materialandVEGF group(group E),6 in each group.After 8-week treatment,the morphology of tissues was observed by hematoxylin and eosin(HE)staining.Rabbit whole blood viscosity(high shear 150 s^(-1) and low shear 10 s^(-1)),plasma viscosity,hematocrit,serum total cholesterol(TC)and triglyceride(TG)were measured.mRNA levels of von Hippel-Lindau(VHL),hypoxia-inducible factor alpha(HIF-1α),VEGF,and basic fibroblast growth factor(b FGF)in femoral head tissue were detected by q RT-PCR.Results As compared with groups C and D,whole blood viscosity(high shear 150 s^(-1)and low shear 10 s^(-1)),plasma viscosity and hematocrit were significantly decreased in group E(P<0.05);so were serum TC and TG(P<0.05).In comparison with groups C and D,level of VHL mRNA in the femoral head tissue was significantly decreasedin group E,while HIF-1α,VEGF and bFGF were significantly increased(P<0.05).Conclusions Core decompression combined with collagen-based bone repair material and VEGF can effectively accelerate osteogenesis and vascular repair in the injured area of ONFH rabbits and reduce microcirculation disturbance.Its mechanism is related to improvement of lipid metabolism and regulation of VHL/HIF-1α/VEGF signal and b FGF expression.