体外冲击波对伴骨质疏松的骨关节炎模型软骨及软骨下骨结构、代谢及功能的影响

发布时间：2018-04-16 19:13

本文选题：骨质疏松 + 骨关节炎　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:分别制备大鼠骨质疏松和骨关节炎模型。方法:8周龄雌性SD大鼠32只,分为4组:A组(假去势组),B组(OP组);C组(假关节炎组),D组(OA组)。B组大鼠去势,术后12周时通过双能X线骨密度仪测定腰椎和股骨的BMD以及通过三点弯曲试验观察股骨力学特性。D组行改良Hulth法,4周时通过关节大体变化和组织切片来验证骨关节炎模型。结果:对于A组和B组:去势12周后,B组大鼠腰椎和股骨的BMD都低于A组且有统计学差别(P0.05);B组大鼠股骨承受的最大应力明显下降(P0.05)。对于C组和D组:术后4周,相比C组,D组关节周围滑膜肿胀以及软骨表面明显退变;HE染色切片也显示:D组软骨结构和细胞损伤严重,Mankin评分明显高于C组(P0.05)。结论:通过去势法12周是成功制备大鼠OP模型的有效方法,通过改良Hulth法(ACL+MM)4周可以成功制备骨关节炎模型。目的:ESWT对伴骨质疏松的骨关节炎模型软骨及软骨下骨结构、代谢及功能的影响。方法:8周龄雌性SD大鼠36只,分为3组:Sham组,OPOA组,ESWT组。OPOA组和ESWT组均去势,在12周验证骨质疏松模型后,通过改良Hulth法制备骨关节炎模型。改良Hulth法术后1周,ESWT组开始在软骨下骨部位给予ESW干预,1周1次,共4次(能量1.6bar,脉冲1000次,频率为5Hz)。干预4周后通过组织形态学和生物力学来观察关节软骨的变化;通过Micro-CT和免疫组化来观察软骨下骨的微结构变化;通过步态分析来观察大鼠的功能变化。结果:相比Sham组,OPOA组的关节周围滑膜增生,软骨表面可见裂纹,且Mankin和toluidine blue评分显著提高。而ESWT组较OPOA组软骨退变有所改善,Mankin也明显降低。生物力学显示:OPOA组的应力应变曲线位移和蠕变显著性增加相对于sham组,经ESW干预4周后,可见关节软骨的力学特性有所恢复,应力应变曲线位移(除了0.02N)和蠕变显著性下降。Micro-CT结果显示:OPOA组软骨下骨微结构明显破坏,BV/TV、Tb.N和Tb.Th都明显减少而Tb.Sp明显增加,ESW干预4周后,BV/TV、Tb.N和Tb.Th都明显增加而Tb.Sp显著性下降。免疫组化显示:OPOA组BMP-2和Osterix蛋白表达明显减少相对于Sham组。经ESW治疗后,BMP-2和Osterix表达都显著性增加。步态分析结果显示:相对于Sham组,OPOA组支撑时相(stance phase),摆动速度(swing speed),和单足支撑时相(single stance phase)显著性缩短。在ESW干预4周后,大鼠步态状态有一定的改善,ESWT组支撑时相(stance phase),摆动速度(swing speed)和单足支撑时相(single stance phase)显著性变长,同时摆动时相(swing phase)显著性缩短。结论:ESW通过干预软骨下骨,既延缓和阻止了OPOA大鼠关节软骨的退变,也从步态方面改善了大鼠的运动功能。
[Abstract]:Objective: to establish rat models of osteoporosis and osteoarthritis.Methods Thirty-two female Sprague-Dawley rats (8 weeks old) were divided into 4 groups: group A (sham ovariectomized group), group B (group B) and group C (group C).BMD of lumbar vertebrae and femur was measured by dual energy X-ray absorptiometry 12 weeks after operation. The mechanical properties of femur in group D were observed by three point bending test. The model of osteoarthritis was verified by gross changes and tissue sections in group D after 4 weeks with modified Hulth method.Results: for group A and group B, the BMD of lumbar vertebrae and femur in group B was lower than that in group A after 12 weeks of castration, and there was significant difference in the maximum stress of femur in group B (P 0.05).For group C and group D: 4 weeks after operation, compared with group C, the swelling of synovium around the joint and the obvious degeneration of cartilage surface in group C and HE staining also showed that the Mankin score of cartilage structure and cell damage in group D was significantly higher than that in group C (P 0.05).Conclusion: the ovariectomized 12 weeks method is an effective method for the successful establishment of rat op model, and the modified Hulth method can be used to establish the osteoarthritis model by using the modified ACL MM)4 week.Objective to study the effects of ESWT on the structure, metabolism and function of cartilage and subchondral bone in osteoarthritis model with osteoporosis.Methods Thirty-six female Sprague-Dawley rats (8 weeks old) were divided into 3 groups: OPOA group, ESWT group, OPOA group and ESWT group. Osteoarthritis model was established by modified Hulth method after the osteoporosis model was verified at 12 weeks.One week after modified Hulth, ESW intervention was given to the subchondral bone once a week for 4 times (energy 1.6 bar. pulse 1000, frequency 5 Hz).After 4 weeks of intervention, the changes of articular cartilage were observed by histomorphology and biomechanics, the changes of microstructures of subchondral bone were observed by Micro-CT and immunohistochemistry, and the functional changes of rats were observed by gait analysis.Results: compared with Sham group, periarticular synovial hyperplasia and cartilage surface cracks were observed, and the scores of Mankin and toluidine blue were significantly improved.The cartilage degeneration in ESWT group was significantly lower than that in OPOA group.Biomechanics showed that the stress-strain curve displacement and creep of the sham group increased significantly compared with that of the sham group. After 4 weeks of ESW intervention, the mechanical properties of articular cartilage recovered.The results of stress-strain curve displacement (except 0.02N) and significant decrease of creep. Micro-CT results showed that the microstructures of subchondral bone in the group of w / w OPOA significantly destroyed BV / TVT Tb.N and Tb.Th, while Tb.Sp significantly increased the number of BV / TVTV-Tb.N and Tb.Th, while Tb.Sp decreased significantly after 4 weeks of intervention.Immunohistochemical staining showed that the expression of BMP-2 and Osterix protein decreased significantly in OPOA group compared with Sham group.After ESW treatment, the expression of BMP-2 and Osterix increased significantly.The results of gait analysis showed that the swing speed and single stance phase of Sham group were significantly shorter than those of Sham group.After the intervention of ESW for 4 weeks, the gait state of rats was improved to some extent. In ESWT group, the phase of stance phase (swing speed) and the phase of single stance phase at one foot support increased significantly, and the phase of swing phase of ESWT group was shortened significantly.Conclusion by interfering with the subchondral bone, the OPOA can not only delay and prevent the degeneration of articular cartilage, but also improve the motor function in gait.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R580;R684.3;R-332

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