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激素性股骨头坏死的骨组织TGF-β1、MMP-2、Run-X2及BGP的表达

发布时间:2018-04-27 00:42

  本文选题:激素性股骨头坏死 + TGF-β1 ; 参考:《广州中医药大学》2014年硕士论文


【摘要】:目的: 观察人和兔激素性股骨头坏死的骨组织中生长转化因子-β1(Transforming Growth Factor-β1, TGF-β1)、金属基质蛋白-2(matrix metall oproteinase-2, MMP-2)、Run相关转录因子2(Runt-related transcription factor2, RunX2)-.骨钙素(Bone gamma-carboxyglutamic-acid-containing proteins, BGP)的表达情况,探讨其在激素性骨坏死修复中的作用机制。 方法: (1)动物实验:健康普通级新西兰家兔20只按完全随机分原则成两大组(实验组10只,对照组10只),实验组于耳缘静脉注射大肠杆菌内毒素12.5μg/kg,24h后重复给药1次,注射完毕后,立即臀肌注射甲基泼尼松龙40mg/kg共3次,每次间隔24h。对照组与实验组相同时间点注射等量生理盐水。末次注射注射用甲泼尼龙琥珀酸钠2个月后,两组兔子行X线片、MRI检查。影像学检查后予过度麻醉处死20只兔子,将兔股骨头标本行固定、脱钙,系列脱水后石蜡包埋石蜡制成切片及HE染色,对标本进行病理检查,最后采用免疫组织化学检测兔股骨头骨组织中TGF-β1、 MMP-2、骨钙素表达水平,采用QPCR检测兔股骨头骨组织中Run-X2信号的表达水平。 (2)临床研究:2013年10月至2014年2月,收集在广州中医药大学第一附属医院三骨科住院的14例需要行全髋关节置换术病例(其中实验组7例全为激素性股骨头坏死ARCOIV期的患者,对照组7例来源为股骨颈骨折、髋关节发育不良、骨性关节炎的患者),术后将14例股骨头标本行固定、脱钙,系列脱水后石蜡包埋石蜡制成切片以及HE染色,对标本进行病理检查,最后采用免疫组织化学检测兔股骨头骨组织中TGF-β1、MMP-2、骨钙素表达水平,采用QPCR检测兔股骨头骨组织中Run-X2信号的表达水平。 结果: 1.动物实验研究:兔实验组X线片检查、MRI检查以及病理检查均示股骨头坏死,对照组X线片检查、MRI检查以及病理检查均无股骨头坏死征象。免疫组织化学检测兔实验组股骨头骨组织中TGF-β1、MMP-2、骨钙素的表达结果较对照组低,差异均具有统计学意义(P0.05);QPCR检测兔实验组股骨头骨组织中Run-X2信号的表达结果较对照组低,差异均具有统计学意义(P0.05) 2.临床研究:人实验组病理检查均显示有股骨头坏死,对照组均未发现股骨头坏死征象。免疫组织化学检测人试验组股骨头骨组织中TGF-β1、MMP-2、骨钙素的表达结果较对照组低,差异均具有统计学意义(P0.05); QPCR检测人试验组股骨头骨组织中Run-X2信号的表达结果较对照组低,差异均具有统计学意义(P0.05)。 结论: 激素性股骨头坏死的机制可能与股骨头骨组织中的TGF-β1、MMP-2、RunX2、骨钙素表达水平过低有关。
[Abstract]:Objective: Growth factor-尾 1(Transforming Growth factor- 尾 1, TGF- 尾 1, metallomatrix protein-2 matrix metall oproteinase-2, MMP-2run related transcription factor 2(Runt-related transcription factor 2, RunX 2 -, were observed in human and rabbit osteonecrosis of femoral head. The expression of osteocalcin gamma-carboxyglutamic-acid-containing proteins (BGP) and its role in the repair of steroid-induced osteonecrosis were investigated. Methods: (1) Animal experiment: 20 healthy New Zealand rabbits of general grade were randomly divided into two groups (10 in the experimental group and 10 in the control group). In the experimental group, E. coli endotoxin 12.5 渭 g / kg / kg was injected intravenously at the ear edge for 24 hours. Methylprednisolone 40mg/kg was injected immediately into gluteus muscle for 3 times with 24 h interval. The control group and the experimental group were injected with the same amount of saline at the same time. Two months after the last injection of methylprednisolone sodium succinate, two groups of rabbits were examined by X-ray and MRI. After imaging examination, 20 rabbits were killed under excessive anesthesia. The femoral head of rabbits were fixed, decalcified, paraffin embedded in paraffin after serial dehydration and stained with HE. The specimens were examined by pathology. Finally, the expression of TGF- 尾 _ 1, MMP-2 and osteocalcin in rabbit femoral head was detected by immunohistochemistry, and the expression of Run-X2 signal was detected by QPCR. (2) Clinical study: from October 2013 to February 2014, 14 patients who were hospitalized in the Department of Orthopaedics, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, required total hip arthroplasty (7 of them in the experimental group were all ARCOIV patients with steroid-induced femoral head necrosis). The control group included 7 patients with femoral neck fracture, hip dysplasia and osteoarthritis. After operation, 14 femoral head specimens were fixed, decalcified, paraffin embedded in series of dehydrated paraffin sections and stained with HE. The expression of TGF- 尾 _ 1 and MMP-2 and osteocalcin in rabbit femoral head were detected by immunohistochemistry, and the expression of Run-X2 signal in femoral head was detected by QPCR. Results: 1. Animal experimental study: in the experimental group, MRI and pathological examination showed necrosis of femoral head, while in the control group, there were no signs of necrosis of femoral head on MRI and pathological examination. The expression of TGF- 尾 1 and MMP-2 and osteocalcin in the femoral head of the experimental group were detected by immunohistochemistry. The difference was statistically significant (P 0.05). The expression of Run-X2 signal in the femoral head of the experimental group was lower than that in the control group. The difference was statistically significant (P0.05). 2. Clinical study: femoral head necrosis was found in human experimental group and no sign of femoral head necrosis was found in control group. The expression of TGF- 尾 1 and MMP-2 and osteocalcin in femoral head of human experimental group were detected by immunohistochemistry, the difference was statistically significant (P 0.05), and the expression of Run-X2 signal in bone tissue of human experimental group was lower than that of control group. The difference was statistically significant (P 0.05). Conclusion: The mechanism of steroid-induced osteonecrosis may be related to the low expression of TGF- 尾 _ 1, MMP-2MMP _ 2, and osteocalcin in femoral head.
【学位授予单位】:广州中医药大学
【学位级别】:硕士
【学位授予年份】:2014
【分类号】:R681.8

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