Bcl-2基因转染骨髓干细胞治疗激素性股骨头坏死的疗效研究

研究Bcl-2 基因转染的骨髓间充质干细胞（BMSCs）结合髓芯减压法对兔早期激素性股骨头坏死的疗效。方法使用共计40只家兔复制早期激素性股骨头坏死模型，其中成功的模型家兔共28 只。随机分为4 组：空白对照组6 只，不作任何处理；髓芯减压组6 只，单纯减压；BMSCs 治疗组8 只，在减压同时植入BMSCs；Bcl-2 治疗组8 只，在减压同时植入Bcl-2 基因转染的BMSCs。植入后分别在第8、12 周各取股骨头标本行病理学检查及骨细胞凋亡检测，观察骨细胞生长及凋亡情况。结果成功复制兔早期激素性股骨头坏死动物模型；培养出BMSCs后进行传代；Bcl -2 基因转染成功；治疗12 周后，Bcl-2 治疗组动物的一般情况改善，组织切片和细胞凋亡检测结果显示，Bcl-2 治疗组的空骨陷窝和骨细胞凋亡数量与其他3 组比较，差异有统计学意义（p <0.05）。结论使用髓芯减压将Bcl-2 基因修饰的BMSCs 移植到兔早期激素性股骨头坏死动物模型体内，具有较好的成骨治疗作用。

Treatment of steroid-induced femoral head necrosis with Bcl-2 gene modified bone marrow mesenchymal stem cells

To explore the curative effect of implantation of bone marrow mesenchymal stem cells (BMSCs) transfected with Bcl-2 combined with core decompression on experimental femoral head necrosis in rabbits. Methods Forty rabbits were selected, and femoral head necrosis models were successfully prepared in28 rabbits. Then, the model rabbits were randomized into 4 groups: blank control group ( n= 6) without treat-ment, core decompression group (n = 6), BMSCs group (n = 8) subjected to core decompression and implantation of BMSCs, and Bcl-2 group ( n= 8) subjected to core decompression and implantation of Bcl-2-transfected BMSCs. In the 8th and 12th week after implantation, femoral head tissues were taken and sliced into sections for pathological examination and detection of osteocyte apoptosis. Results gene was successfully trans-fected into BMSCs. At the 8th week after implantation, there was only a little new bone formation in the core decompression group and the BMSCs group; at the 12th week, fibrous tissues were formed in the decompression channel. In the Bcl-2 group, new bone formation was observed, and at the 12th weeks, the necrotic region was completely repaired. The positive TUNEL staining of the Bcl-2 group was much less than that of the other groups, the differences were significant (p < 0.05). Conclusions These findings indicate that Bcl-2-transfected bone marrow mesenchymal stem cell transplantation via core decompression has better curative effect on exper-imental femoral head necrosis in rabbit model.