【摘要】 目的观察体外冲击波疗法(ESWT)对兔缺血坏死股骨头内骨形态发生蛋白(BMP)表达及骨质再生的影响。方法选取体重3-4kg健康新西兰大白兔33只,雌雄不限,采用脂多糖和甲基强的松龙制造股骨头缺血坏死模型。每只兔左股骨头接受冲击波治疗,设为实验组,右股骨头不做任何处理,设为对照组。在冲击波治疗后1,2,4,8,12周处死动物取双侧股骨头进行HE染色观察组织学改变,免疫组化观察BMP表达的情况,用空骨陷窝率、成骨细胞计数及四环素荧光标记染色评价骨质再生的情况。结果在实验组,冲击波治疗后2周BMP开始表达,4周达到高峰,12周仍很高,BMP表达最强的区域在坏死后增殖区。成骨细胞在2周开始增多,4周达到高峰,12周仍很密集。而在对照组,只有少量的BMP表达和成骨细胞出现。与对照组相比,实验组股骨头成骨细胞计数及四环素标记积分光密度值在4周(P<0.05),8周和12周显著增高(P<0.01),而空骨陷窝率在4周(P<0.05),8周和12周显著降低(P<0.01)。结论ESWT可以促进兔缺血坏死股骨头内BMP的表达进而促进骨质的再生。更多还原

【Abstract】 Objective To investigate the effect of extracorporeal shock waves on bone morphogenetic protein(BMP)expression and bone formation in avascular necrosis of femoral heads of rabbits. Methods Thirty-three New Zealand white rabbits,weighted from 3.0 to 4.0 kg,were given methylprednisolone and lipopolysaccharide for establishing avascular necrosis models of femoral head.Shock wave therapy was given to the femoral head of left limb(experiment group),but not in right limb(control group).Hematoxylin-eosin staining was used to observe the histological changes of avascular necrosis of femoral head at week 1,2,4,8 and 12 after treatment.BMP expression was assessed by immunohistochemistry.The percentage of empty lacunae,the osteoblast number and tetracycline fluorescence marker were used to evaluate the bone formation. Results In experiment group,BMP began to express at week 2 after treatment,peaked at week 4 and persisted until week 12.The most intensive BMP immunoreactivity was observed in the proliferative zone above the necrotic zone.Osteoblast number in experiment group started to increase at week 2,peaked at week 4 and persisted until week 12.The expression of BMP and osteoblast number were scarce in control group.At week 4,8 and 12 after treatment,integral optical density(IOD)of tetracycline fluoresence labeling in experiment group was significantly higher than in control group(P<0.05 or P<0.01).At week 4,8 and 12 after treatment,the percentage of empty lacunae in experiment group was significantly lower than in control group(P<0.05 or P<0.01). Conclusion Extracorporeal shock waves can up-regulate the expression of BMP and induce new bone formation in the avascular necrosis of rabbit femoral head.更多还原