关节腔内注射臭氧对骨关节炎软骨作用的实验研究

目的探讨医用臭氧直接在关节腔内注射对骨关节炎（OA）软骨的作用。方法32只新西兰兔随机均分为4组：正常对照组（N）、模型对照组（M）、低剂量臭氧组（L）和高剂量臭氧组（H），每组8只。M、L、H三组分别于第1、4实验日经右膝关节腔内注射1．6％papain溶液0．3ml制备OA动物模型。成功建模1周后，L、H组右膝关节腔内注射浓度分别为20μg/ml和40μg/ml的医用臭氧2ml，每周两次，共4周。末次注射后1周处死全部实验兔，截取胫骨内侧平台做病理学观察并进行Mankin评分。结果M、L、H三组胫骨内侧平台软骨均出现骨关节软骨损害改变，L、H组损害比M组严重，而H组又比L组严重；Mankin评分从正常组－模型组－低剂量臭氧组－高剂量臭氧组逐步递增，组间差异有统计学意义（P〈0．01）。结论关节腔内反复注射臭氧后，对膝关节OA软骨产生了进一步损害的作用，损伤程度随臭氧浓度的增加而加重。

Experimental study of medical ozone intra-articular injection in papain induced osteoarthritis models

Objective To evaluate the local effect of intra-articular Ozone injection on the articular cartilage of osteoarthritis. Methods 32 New Zealand white rabbits were randomly divided into 4groups： group N of normal rabbits, group M of OA models without treatment, group L of OA models treated with low dosage 03 （20μg/ml） and group H of OA models treated with high dosage （40 μg/ml）. Each group had 8 rabbits. OA model was produced by injecting 0. 3 ml of 1.6% papain solution into the knee joint space twice three days apart. 7 days after the last injection of papain solution, the rabbits of both L and H groups were treated with intra-articular injections of different ozone dosage accordingly twice a week for 4 weeks. N and M groups underwent no special treatment. 1 week after the last Ozone injection, all animals were sacrificed to collect cartilage at the medial side of the tibia platform for pathological analysis and evaluated by Mankin Score. Results Damage of cartilage at the medial side of the tibia platforms were found in M, L and H groups to a different extent which were severer in L and H groups than in M group, and severest damage were found in H group. Mankin scores of groups increased by degrees from group N, M, L to H, the differences among the groups were statistically significant （ P 〈 0. 01 ）. Conclusions The study indicated that repeated injections of ozone to joint cavity may have an adverse deleterious effect on OA-like articular cartilage, and the degree of damage appeared to be ozone dosage dependent.