兔骨坏死与骨质疏松组织病理学变化的比较研究
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摘要
目的：建立骨质疏松和骨坏死的大白兔模型,比较骨坏死与骨质疏松病理学变化的异同点,进一步探讨骨质疏松与骨坏死两者的相互关系及相关机制。方法：取32只3月龄雌性新西兰大白兔,随机分成4组即A组(肌注激素组,8只。)B组(去势组,8只。)C组(去势+肌注激素组,8只。)D组(空白对照组：假手术+肌注生理盐水组,8只。)B、C两组动物取下腹部正中切口,完整切除双侧卵巢,A、D两组除未行卵巢结扎切除外,其余步骤同B、C两组。术中甲硝唑冲洗腹腔,术后所有动物每周臀肌注射一次青霉素10万U/kg。手术1周后A、C两组动物予臀肌注射氢化可的松7.5mg/kg,每周两次,B、D两组动物予等量生理盐水臀肌注射。分别在给药后5周、10周后行骨密度(BMD)检测,并处死4只,取双侧股骨头,行HE染色、油红O染色及扫描电镜检测。结果：A组、B组和C组在术后5周腰椎BMD(单位mg/cm2)较术前(246±19 vs 269±13、256±22 vs 269±13、236±22 vs 273±16)及D组同时期(272±19)均减低,术后10周腰椎BMD较术前(221±13 vs 269±13、222±18 vs 269±13、185±11 vs 273±16)及D组同时期(263±23)均明显减低(P<0.05)。A组、B组和C组术后5W股骨近端BMD较术前(256±20 vs 306±24、264±20 vs 306±21、236±46 vs 301±22)及D组同时期(305+23)均减低,术后10周股骨近端BMD(230±22 vs 306±24、230±17 vs 306±21、189±39 vs 301±22)及D组同时期(297±28)均明显减低(P<0.05)。但只有C组术后10周的BMD小于术前及D组同时期BMD均值减去2.0SD(P<0.05)。造模后5周,A、B、C三组空骨陷窝阳性率(%)较D组明显增高(15.20±1.09、14.13±1.05、18.53±0.67 vs10.40±0.97,P<0.05)。A、B、C三组骨小梁可见不同程度的稀疏,部分断裂。造模后10周,A、B、C三组空骨陷窝阳性率较D组明显增高(22.43±0.78、21.20±1.19、26.78±1.21 vs 11.13±0.87,P<0.05)。A、B、C三组股骨头成不同程度的骨髓腔内脂肪细胞增生,骨小梁稀疏变细,结构紊乱、断裂,空骨陷窝增多。D组股骨头骨小梁致密,骨陷窝内骨细胞形态正常,分布均匀,骨髓腔内脂肪细胞形态正常,含量适中。结论：通过去势及肌注激素建立了骨坏死与骨质疏松的动物模型,在早期两个疾病具有相似的病理学改变,但也有不同之处,骨质疏松的发生主要是由于影响了成骨细胞和破骨细胞的活性及二者的平衡；骨坏死的发生由脂肪细胞的增生、骨细胞脂肪变性起主导作用。为进一步讨论骨坏死与骨质疏松的发病相关性及调控机制具有重要的理论和实践意义。
Objective:To establish the models of Osteonecrosis and osteoporosis of bone with white rabbit, to explore the correlate relationship and mechanism according to comparison the changes between them. M ethods:32 3-months old female New Zealand white rabbits were divided randomly into 4 groups:Group A (intramuscular hormone, n=8); Group B (spaying, n=8); Group C (spaying+intramuscular hormone, n=8); Group D (normal control group, sham operation+intramuscular normal saline, n=8). The models were spayed via the hypogastrium median incision in Group B,C, the steps were same of the models in Group A,D except for spaying. The models were underwent abdominal irrigation with metronidazole during operation and were intramuscular with 100 thousand unit penicillin per kilogram once a week for infection prevention. The models were intramuscular with hydrocortisone 7.5 milligram per kilogram twice a week in Group A,C at 1 week postoperatively. Models in Group B, D were intramuscular with identical capacity normal saline. The bone mineral density of the models were determined after drug administration at 5 and 10 weeks respectively, then the bilateral femoral head of 4 models were taken with HE dyeing,oil red O dyeing and detected with scanning electron microscope. Results: The BMD of lumbar and femoral near-end of models at the 5th and 10th weeks postoperatively were significantly decreased in Group A, B and C than preoperation and the same period in Group D(P<0.05). The mean values of BMD in 10 weeks postoperatively in Group D were significantly decreased than preoperation and the mean values minus 2.0SD of the same period in Group D(P<0.05). The positive rate of empty bone lacunas were significantly increased in Group A, B, C than Group D(P<0.05), and the trabeculae showed different degree of porotic, some fractured in Group A, B, C at the 5th week after modeling. The positive rate of empty bone lacunas were significantly increased in Group A, B, C than Group D(P<0.05), and The different degree hyperplasia of fat cells existed in femoral head marrow cavity, the trabeculae showed porotic, manifesting thinning, disorganization, fragmentation at the 10th week. Yet the trabeculae were compact, eumorphism and homogeneous distribution in bone lacunas, the fat cell were normomorph and moderate in bone marrow in Group D. Conclusion:The white rabbit model of avascular necrosis of the Femoral Head and osteoporosis are established successfully by spaying and intramuscular hormone. There are similar pathology changes in the early period between two diseases, but they are different. Osteoporosis is mainly due to the influence of the activity of osteoblast and osteoclast,and the balance between them.The hyperplasia of adipocyte and the fatty degeneration of osteocyte play a leafing role in the course of osteonecrosis.It is of far reaching important in theory and practice to investigate the pathogenesis and regulation of osteonecrosis and osteoporosis.
Objective:To establish the models of Osteonecrosis and osteoporosis of bone with white rabbit, to explore the correlate relationship and mechanism according to comparison the changes between them. M ethods:32 3-months old female New Zealand white rabbits were divided randomly into 4 groups:Group A (intramuscular hormone, n=8); Group B (spaying, n=8); Group C (spaying+intramuscular hormone, n=8); Group D (normal control group, sham operation+intramuscular normal saline, n=8). The models were spayed via the hypogastrium median incision in Group B,C, the steps were same of the models in Group A,D except for spaying. The models were underwent abdominal irrigation with metronidazole during operation and were intramuscular with 100 thousand unit penicillin per kilogram once a week for infection prevention. The models were intramuscular with hydrocortisone 7.5 milligram per kilogram twice a week in Group A,C at 1 week postoperatively. Models in Group B, D were intramuscular with identical capacity normal saline. The bone mineral density of the models were determined after drug administration at 5 and 10 weeks respectively, then the bilateral femoral head of 4 models were taken with HE dyeing,oil red O dyeing and detected with scanning electron microscope. Results: The BMD of lumbar and femoral near-end of models at the 5th and 10th weeks postoperatively were significantly decreased in Group A, B and C than preoperation and the same period in Group D(P<0.05). The mean values of BMD in 10 weeks postoperatively in Group D were significantly decreased than preoperation and the mean values minus 2.0SD of the same period in Group D(P<0.05). The positive rate of empty bone lacunas were significantly increased in Group A, B, C than Group D(P<0.05), and the trabeculae showed different degree of porotic, some fractured in Group A, B, C at the 5th week after modeling. The positive rate of empty bone lacunas were significantly increased in Group A, B, C than Group D(P<0.05), and The different degree hyperplasia of fat cells existed in femoral head marrow cavity, the trabeculae showed porotic, manifesting thinning, disorganization, fragmentation at the 10th week. Yet the trabeculae were compact, eumorphism and homogeneous distribution in bone lacunas, the fat cell were normomorph and moderate in bone marrow in Group D. Conclusion:The white rabbit model of avascular necrosis of the Femoral Head and osteoporosis are established successfully by spaying and intramuscular hormone. There are similar pathology changes in the early period between two diseases, but they are different. Osteoporosis is mainly due to the influence of the activity of osteoblast and osteoclast,and the balance between them.The hyperplasia of adipocyte and the fatty degeneration of osteocyte play a leafing role in the course of osteonecrosis.It is of far reaching important in theory and practice to investigate the pathogenesis and regulation of osteonecrosis and osteoporosis.
引文
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