股骨颈骨折后股骨头骨细胞凋亡与bcl-2和TNF-α表达的关系

A CLINICOPATHOLOGICAL STUDY OF OSTEOCYTES APOPTOSIS AFTER FEMORAL NECK FRACTURE

①目的 了解股骨颈骨折后骨细胞的凋亡情况并探讨其发生的可能病理机制。②方法 采用免疫组织化学 (PV 90 0 0法 )及TUNEL法 ,对 6 0例 (分为早、中、晚期组 )股骨颈骨折病人的股骨头标本进行组织学观察 ,bcl 2、TNF α表达及细胞凋亡检测。③结果 6 0例标本中均可见到不同程度的空骨陷窝化 ,并可见到骨细胞的凋亡。bcl 2表达中期组较早、晚期组强 ,TNF α表达晚期组较早、中期组强 ,细胞凋亡晚期组较中期组显著 ,差异均有统计学意义 (H =6 .5 32、7.2 36 ,q =4 .2 38～ 6 .32 1,P <0 .0 5 )。④结论 股骨颈骨折后骨细胞出现不同程度的凋亡 ,若在股骨颈骨折后的 10～ 2 0d内采取恰当的临床干预治疗 。

Objective To study osteocytic apoptosis following femoral neck fractures and to discuss the possible pathological mechanisms. Methods The pathological and immunohistochemical features of 60 cases were evaluated and osteocytic apoptosis was studied with TUNEL. Results Empty osteocyte lacunae of different degrees and osteocytic apoptosis appeared in all 60 cases. The expression of bcl-2 in medium period group was higher than that of the early and late period groups. The expression of TNF-α in late period group was higher than that of the early and medium period groups. Osteocytic apoptosis was more significant in the late period group than in the medium period group. All the differences between three groups were statistically significant ( H=6.532,7.236, q=4.238-6.321,P<0.05). Conclusion Osteocytic apoptosis of different degrees appears after femoral neck fractures. Proper intervention within 10-20 days after femoral neck fracture might favor the healing of the fracture.