兔膝骨性关节炎CT引导下臭氧干预对关节软骨部分免疫指标的影响

发布时间：2018-03-13 01:21

本文选题：骨性关节炎　切入点：臭氧　出处：《山西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的： 1.CT导引下成功建立兔膝骨性关节炎动物模型,选择关节软骨最佳MR成像序列,并做分组对照观察 2.探讨CT导引下O3干预治疗兔膝骨性关节炎,观察实验兔关节软骨部分炎性介质IL-1、TNI-a、MMP-13的表达情况 3.本课题将兔膝关节炎关节软骨MR上微细变化与免疫组化表达相对照,来进一步探讨臭氧对软骨细胞的影响及其机制方法： 1、建立动物模型将4%木瓜蛋白酶0.3m1通过关节腔内注射法注入兔膝关节的双后肢,制成兔膝骨性关节炎模型。 2.动物分组随机抽取6只实验兔作为对照组,通过MR双侧兔膝关节检查,将剩余成功造模后的实验动物随机分为：骨性关节炎组,医用臭氧组,玻璃酸钠组。正常对照组及骨性关节炎组不做任何处理,玻璃酸钠组向双侧膝关节腔内每次每侧注射1%浓度的SH1ml,注射频率为1次/周,连续4周注射；医用臭氧组向双膝关节内每次第侧注入浓度为35ug/ml臭氧5ml；注射频率为1次/周,连续4周注射,治疗1周后再次对双侧膝关节行MR检查,完成后一并处死所有实验动物。 3..软骨组织中IL-1、TNF-a及MMP-13的检测切取实验兔双侧股骨内侧髁关节软骨并修剪成1×1×2mm3小长条,采用DAB法检测关节软骨细胞IL-1、TNF-a及MMP-13的阳性表达。结果： 1.CT引导下兔膝骨性关节炎动物模型成功建立。 2.臭氧干预治疗兔膝骨性关节炎前后,软骨组织中IL-1、TNF-a及MMP-13的表达存在变化且其变化趋势较一致。 3.IL-1、TNF-a及MMP-13阳性表达率：OA、03、SH三组均高于正常对照组(P0.05),03组与SH组低于OA组(P0.05)。03组与SH组无统计学意义(P0.05)。 4.MR检查及免疫组化结果显示,实验组兔膝关节腔内注射臭氧或玻璃酸钠,均对关节炎病变有一定抑制作用,两种治疗方法的疗效差异无统计学意义。结论： 1.臭氧干预治疗兔膝骨性关节炎,能引起软骨组织中IL-1、TNF-a及MMP-13这三种炎性介质表达程度的改变,且其变化趋势与免疫组化结果表达情况较一致。 2.医用臭氧经膝关节腔内注射对骨关节炎动物模型的关节软骨有修复作用,使关节软骨中IL-1、TNF-a、MMP-13表达减少,软骨表面较光整、裂隙生成减少、细胞增生等退变延缓现象,MR上显示各组实验兔关节软骨上存在着信号变化,由此可见IL-1、TNF-a、MMP-13的表达减少与病理及MR上变化的软骨退变好转对应,证明臭氧具有治疗骨关节炎的潜在可能性。
[Abstract]:Objective:. 1. The animal model of rabbit knee osteoarthritis was successfully established under the guidance of CT, and the optimal Mr imaging sequence of articular cartilage was selected and compared with each other. 2. To investigate the treatment of knee osteoarthritis with O3 under the guidance of CT, and observe the expression of TNI-a MMP-13, a partial inflammatory mediator of articular cartilage, in rabbits. 3. In order to further explore the effect of ozone on chondrocytes and its mechanism, we compared the fine changes of articular cartilage on Mr and the expression of immunohistochemistry in rabbit knee arthritis. Methods:. 1. Establish animal model. The rabbit knee osteoarthritis model was established by injecting 4% papain 0.3 M1 into the hind limbs of the knee joint. 2. Animal subgroup. Six experimental rabbits were randomly selected as control group. The remaining rabbits were randomly divided into osteoarthritis group and medical ozone group. Sodium hyaluronate group. The normal control group and osteoarthritis group did not do any treatment. Sodium hyaluronate group injected 1% concentration of SH1 ml into each side of bilateral knee joint each time, the injection frequency was once a week for 4 weeks. In the medical ozone group, the concentration of ozone at the first side of each knee joint was 35ug-ml / ml, and the injection frequency was once a week for 4 weeks. After one week of treatment, the bilateral knee joints were again examined by Mr, and all the experimental animals were killed after the completion of the injection. 3. Detection of IL-1TNF- 伪 and MMP-13 in chondrocytes. The articular cartilage of bilateral medial femoral condyle was cut and pruned into 1 脳 1 脳 2 mm3 strips. The expression of IL-1TNF-a and MMP-13 in articular chondrocytes was detected by DAB method. Results:. 1. The animal model of knee osteoarthritis was successfully established under CT guidance. 2. The expression of IL-1TNF-a and MMP-13 in cartilage tissue of rabbits with knee osteoarthritis treated by ozone intervention was changed and the change trend was consistent. 3. The positive expression rates of TNF-a and MMP-13 in the three groups were higher than those in the normal control group (P 0.05) and SH group (P 0.05). There was no significant difference between the three groups (P 0.05) and SH group (P 0.05). 4. The results of Mr and immunohistochemistry showed that the injection of ozone or sodium hyaluronate into the knee joint of the experimental group had a certain inhibitory effect on the pathological changes of arthritis, and there was no significant difference between the two treatment methods. Conclusion:. 1. Ozone intervention in the treatment of knee osteoarthritis caused changes in the expression of IL-1TNF- a and MMP-13 in cartilage tissue, and the change trend was consistent with the expression of immunohistochemical results. 2.Intra-articular injection of medical ozone can repair the articular cartilage of the animal model of osteoarthritis, which can reduce the expression of IL-1TNF- 伪 MMP-13, smooth the cartilage surface and decrease the formation of cracks in the articular cartilage. The signal changes on the articular cartilage of the experimental rabbits showed that the decrease of the expression of MMP-13 in TNF-a was correlated with the pathological changes and the change of cartilage degeneration on Mr. Ozone is a potential therapy for osteoarthritis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R684.3;R816.8

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