TGF-β及BMP-2的表达与酒精性和激素性股骨头坏死关系的对比研究

发布时间：2018-04-28 13:02

本文选题：转化生长因子 + 骨形态发生蛋白　；参考：《河南大学》2015年硕士论文

【摘要】：目的:研究酒精性股骨头坏死以及激素性股骨头坏死两组非创伤性股骨头坏死的病理改变与转化生长因子-β(TGF-β)的活性大小和骨形态发生蛋白-2(BMP-2)强弱的不同表达情况及临床意义,为临床治疗股骨头坏死提供参考,以改善治疗。方法:选择2010年1月至2013年1月整三年中,在我医院住院期间依据X线、CT扫描、MRI扫描等影像资料诊断明确的酒精性股骨头坏死患者以及依据X线、CT扫描、MRI扫描等影像资料激素性股骨头坏死者60例作为实验组,选取新鲜股骨颈骨折30例作为对照组。股骨头坏死的病因非常复杂,根据具体病因不同,我们的实验组选择经X线、CT扫描、MRI扫描等影像资料诊断明确的激素性股骨头坏死患者30例及X线、CT扫描、MRI扫描等影像资料诊断明确的酒精性股骨头坏死患者30例,将其分为两组。在肉眼裸视及光镜放大下,大体观察所选组织学标本的病变情况,利用免疫组化方法检测各组标本中的TGF-β与BMP-2的表达情况,并将二者进行比较。结果:酒精性和激素性股骨头坏死组,在肉眼裸视及光镜放大下病理改变大概相似,这两种股骨头坏死组的骨陷窝面积与脂肪细胞长径及空骨陷窝率与股骨颈骨折正常组相比明显增加(P0.05),并且软骨成骨指数、血管形成以及新生骨小梁等均比股骨颈骨折组明显增加(P0.05);两种股骨头坏死组间的骨小梁面积、脂肪细胞长径、空骨陷窝率、新生骨小梁面积等,酒精组明显高与激素组(p0.05);两种股骨头坏死组之间软骨成骨指数相比较,酒精组明显低于激素组(p0.05)。通过免疫组化来检测TGF-β与BMP-2的表达,结果显示是酒精性股骨头坏死组与激素性股骨头坏死组样本中的TGF-β与BMP-2的阳性面积百分比低于股骨颈骨折组即正常对照组,股骨颈骨折组即正常对照组的平均光密度都明显高于两实验组(P0.05);酒精性股骨头坏死组与激素性股骨头坏死组,这两组间标本中TGF-β的表达无明显差异(p0.05);两组之间标本进行比较,激素性股骨头坏死组的BMP-2的阳性面积百分比低于酒精性股骨头坏死组,激素性股骨头坏死组的光密度则明显高于激素性股骨头坏死组(P0.05);分析TGF-β与BMP-2这两者之间表达的关系,可以看出,TGF-β与BMP-2这两者的阳性面积百分比呈现正相关性,同样,TGF-β与BMP-2这两者的光密度也呈正相关性(P0.05)。结论:1.激素性和酒精性股骨头坏死的病人,两组坏死股骨头的大体外观及显微组织学结构都发生了部分变化,尤其是骨小梁面积大小比正常组明显减少,而同源软骨细胞数量更比正常组减少。2.激素性和酒精性股骨头坏死患者,所选标本中的TGF-β与BMP-2表达水平都接近正常,不同的病因引起股骨头坏死致其表达强度有所改变。由此可以推论,适度增加血液中患者病变局部TGF-β与BMP的浓度及数量可以促进坏死股骨头的修复。
[Abstract]:Objective: to study the pathological changes and the activity of transforming growth factor- 尾 (TGF- 尾) and the different expression and clinical significance of bone morphogenetic protein (BMP) -2BMP-2 in alcoholic and steroid-induced osteonecrosis of femoral head. To provide a reference for clinical treatment of femoral head necrosis in order to improve the treatment. Methods: for the entire three years from January 2010 to January 2013, In our hospital, 60 cases of steroid-induced osteonecrosis of femoral head were diagnosed according to X-ray CT scan and MRI scan, and 60 cases of steroid-induced femoral head necrosis according to X-ray CT scan and MRI scan were used as experimental group. Thirty cases of fresh femoral neck fracture were selected as control group. The causes of osteonecrosis of the femoral head are very complex, depending on the cause. In our experimental group, 30 cases of steroid-induced necrosis of femoral head and 30 cases of alcoholic necrosis of femoral head were diagnosed by X-ray CT scanning and MRI scanning. Divide it into two groups. The pathological changes of the selected histological specimens were observed under naked vision and magnification with light microscope. The expression of TGF- 尾 and BMP-2 in each group was detected by immunohistochemical method, and the two were compared. Results: the pathological changes of alcoholic and steroid-induced femoral head necrosis groups were similar under naked vision and optical magnification. Compared with the normal femoral neck fracture group, the bone lacunae area, adipocyte long diameter and empty bone lacuna rate in these two femoral head necrotic groups increased significantly (P 0.05), and the cartilage osteogenesis index. The area of trabecular bone, adipocyte length, the rate of empty bone trabeculae, the area of new bone trabeculae, and the area of new bone trabeculae were significantly increased in the two kinds of femoral head necrosis groups compared with the femoral neck fracture group. The osteogenesis index of cartilage in alcohol group was significantly higher than that in hormone group (P 0.05), and the osteogenesis index of cartilage in alcohol group was significantly lower than that in hormone group (P 0.05). The expression of TGF- 尾 and BMP-2 was detected by immunohistochemistry. The results showed that the percentage of positive area of TGF- 尾 and BMP-2 in the samples of alcoholic and steroid-induced femoral head necrosis group was lower than that of femoral neck fracture group or normal control group. The average optical density of femoral neck fracture group (normal control group) was significantly higher than that of the two experimental groups (P 0.05), the expression of TGF- 尾 was not significantly different between the alcoholic femoral head necrosis group and the steroid-induced femoral head necrosis group, and there was no significant difference in the expression of TGF- 尾 between the two groups. The percentage of BMP-2 positive area in steroid-induced femoral head necrosis group was lower than that in alcoholic femoral head necrosis group, and the optical density of steroid-induced femoral head necrosis group was significantly higher than that of steroid-induced femoral head necrosis group (P0.05). It can be seen that the positive area percentage of TGF- 尾 and BMP-2 is positively correlated with the optical density of TGF- 尾 and BMP-2. Conclusion 1. In the patients with steroid-induced and alcoholic femoral head necrosis, the gross appearance and microscopic structure of the necrotic femoral head were partly changed, especially the size of trabecular bone was significantly smaller than that of the normal group. The number of homologous chondrocytes decreased by 2. 2. The expression levels of TGF- 尾 and BMP-2 in the selected specimens were close to normal in the patients with steroid-induced and alcoholic femoral head necrosis, and the expression intensity of TGF- 尾 and BMP-2 was changed due to different etiology of osteonecrosis of femoral head. It can be concluded that moderate increase in the concentration and quantity of TGF- 尾 and BMP can promote the repair of necrotic femoral head.
【学位授予单位】：河南大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.8

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