【作者】 李伟；

【导师】 肖德明；

【作者基本信息】 暨南大学 ， 外科学， 2006， 硕士

【摘要】 目的 研究5-氟尿嘧啶(Flurouracil，5-Fu)、透明质酸钠(sodium hyaluronate，SH)、曲安奈德(triamcinolone acetonide，TA)关节腔内注射对兔膝骨性关节炎的治疗效果。 方法 40只兔随机分正常组、5-FU组、SH组、TA组、对照组，其中5-FU组、SH组、TA组、对照组骨关节炎造模后给予5-FU、SH、TA、生理盐水关节腔内注射，正常组给予生理盐水关节腔内注射。每周一次，四周后观察各组软骨和滑膜组织病理切片，以及进行血液和关节液的IL-1的检测、软骨和滑膜MMP-1免疫组化研究、Mankin’s评分、大体观察评分。 结果 5-FU、SH、TA病理切片观察较对照组滑膜细胞减少，滑膜下层的纤维增生减轻，软骨细胞凋亡减少、软骨基质结构完整、基质成份丰富，其中5-FU组与正常组接近。血液和关节液的IL-1的检测、Mankin’s评分显示SH、TA、5-FU与对照组都有明显差异(p＜0.01)，而5-FU明显好于SH、TA(p＜0.05)，SH、TA没有明显差异(p＞0.05)；大体观察、软骨和滑膜MMP-1免疫组化研究显示SH、5-FU与对照组都有明显差异(p＜0.01)，5-FU明显好于SH、TA(p＜0.05)，SH明显好于TA(p＜0.05)。 结论 5-FU、SH、TA关节腔内注射对兔骨性关节炎都有治疗作用，但5-FU比SH、TA的疗效更好，这为治疗膝骨性关节炎提供一种更好的药物和治疗方案的选择。在减轻软骨损害程度上，SH明显好于TA。更多还原

【Abstract】 ObjectiveTo observe the effects of intraarticular injection of 5-fluorouracil、sodium hyaluronate, triamcinolone acetonide on treatment of osteoarthritis.MethodForty male rabbits were randomly divided normal group, 5-FU group, SH group、TA group and control group. 5-FU group 、SH group、TA group and control group were received intraarticular 5-FU、SH、TA and physiologic injection one time a week at the same time respectively after established the model of OA. Normal group was received intraarticular physiologic injection one time a week at the same time. After four weeks, the histological examinations of cartilage and synovium、immunohistochemistry and morphometric analyses of MMP-1 for cartilage and synovium、 Mankin’s scale、macroscopic observation were performed. The level of IL—1 of the serum and synovial fluid were determined by ELISE.ResultThe histological observation of 5-FU、SH、TA group showed they could decrease the synoviocytes and inhibit fibrous hyperplasia in synovial underlayer compare to control group, they also showed they can reduced the apoptosis of chondrocytes and kept more integrated structure of matrix and more glycosaminoglycan, which the group of 5-FU is close to normal. The level of IL-1 of the serum and synovial fluid, Mankin’s scale were showed they all decreased compare the control group(P<0.01). The 5FU group was more better than SH group and TA group (P<0.05). The SH group and TA group have nonsignificantly (P>0.05)Morphometric analyses of MMP-lfor cartilage and synovium、 macroscopic observation were showed the 5-FU, SH group group was more better than control group (P<0.01). The 5FU group was more better than更多还原