【摘要】 目的　探讨激素性股骨头坏死过程中血栓前状态的出现及其诊断学意义。方法　 4 0只兔随机分成 4组 ,每组 10只。A组 :间隔 2 4h耳缘静脉内两次注射大肠杆菌内毒素 ,每次 4 0 μg kg。B组 :注射方法同A组 ,第二次注射内毒素后立即注射一次醋酸强地松龙 2 0mg kg。C组 :一次耳缘静脉内注射醋酸强地松龙 2 0mg kg。D组 :空白对照组。各组分别在注射后 2 4h、7d及 2 1d ,进行血小板、血脂和血浆粘度测定 ,2 1d取股骨头行病理组织学观察。结果　 1、A及B组用药后 2 4h血小板计数减少 (P <0 0 1) ,血浆粘度、血脂升高 (P <0 0 1) ,用药后 7d、2 1d ,A组各项指标逐渐恢复 ,B组持续异常 ,与A组相比差异显著 (P <0 0 1)。C组用药后 7d及 2 1d血小板降低 (P <0 0 1)、血浆粘度和血脂水平明显升高 (P <0 0 1)。B组 2 1d股骨头病理切片见骨细胞变性、坏死 ,较A、C组为重。结论　激素通过增强由内毒素引起的血栓前状态 ,形成血栓导致骨坏死 ,血栓前状态的检测对于激素性股骨头坏死的诊治有重要的参考价值更多还原

【Abstract】 Objective TO study prethrombotic status and its diagnostic significance in the steroid induced necrosis of the femoral head. Methods 40 rabbits were randomly divided into 4 groups. In group A ,10 rabbits were given 40 μgkg -1 of LPS intravenously 2 times at an interval of 24 hours. In group B, 10 rabbits were given LPS as in group A and immediately injected intravenously with 20mg -1 of prednisoloni acetates once time. In group C, 10 rabbits were only injected intravenously with 20 mg -1 of prednisoloni acetates once time. In group D, 10 rabbits were used as control. At the 24th hour, 7th, 21st day after the injection, the blood platelet levels, hemorrheological index and blood lipid levels were measured. At the 21st day, the femoral head were undertaken the histological examination. Results The 24th hour after the 2nd injection, in group B and A, the blood platelet levels decreased( P <0.01), hemorrheological index and blood lipid levels increased( P <0 01), at the 7 and 21 day, the difference of the plasma viscosity and blood lipid levels and at the 21 day the blood platelet levels between group B and A was significant( P <0 01). Histologically, the 21st day after the injection, osteocytes in group B showed the acute degeneration and necrosis. Conclusion Exogenous steroids potentiate the prethrombotic status and induce the thrombus formation. prethrombotic status is the important link in steroid induced necrosis of the femoral head and have higher values for the diagnosis of this disease.更多还原