ESWT对兔激素性股骨头缺血坏死GMP-140、TM、OPG表达的影响

目的：观察兔激素性股骨头缺血坏死体外冲击波疗法（ESWT）干预后，血浆中血小板α-颗粒膜蛋白（GMP-140）、血栓调节蛋白（TM）及骨保护素（OPG）的表达。方法：选取健康成年雄性日本大耳兔50只，激素造模后随机处死2只验证造模成功，其余按随机数字表法分为模型对照组（A组）24只和冲击波治疗组（B组）24只。干预前，两组随机选取8只兔耳动脉采血测血浆GMP-140、TM、OPG含量；ESWT干预第2、4、8周时A、B组各随机选取8只兔，耳动脉采血后处死，测血浆GMP-140、TM、OPG含量；留取股骨头标本行HE染色观察大体病理变化，免疫组化观察股骨头中OPG阳性表达，并进行半定量分析。结果：ESWT干预2、4、8周后，B组血浆中的GMP-140、TM含量较A组均降低（P〈0.05）；ESWT干预4周、8周时B组血浆中OPG含量较A组均升高（P〈0.05）。ESWT干预2、4、8周时B组股骨头中的OPG阳性表达较A组均升高（P〈0.05）。结论：兔激素性股骨头坏死ESWT干预可使血浆中OPG含量增高，GMP-140、TM含量降低，局部坏死区OPG表达增强。

The Effect of ESWT about the Rabbit with Steroid-induced Avascular Necrosis of Femoral Head on GMP- 140,TM and OPG

Objective：To observe the variation of GMP-140,TM and OPG in the plasma of rabbits with steroid-induced avascular necrosis of femoral head under the ESWT intervention.Method：50 male Japanese rabbits were given the steroids to build the models. After the models were built,2 rabbits were chose randomly and killed to verify the models were successful. The rest of the rabbits were divided into the model group（the group A）and the ESWT intervention group （the group B）,each group had 24 cases. 8 rabbits in each group were chose randomly to measure the plasma GMP-140, TM,OPG in ear artery blood before the ESWT intervention. After the ESWT intervention 2,4,8 w,8 rabbits in each group were chose randomly to measure the plasma GMP-140,TM,OPG then they were killed to collect the specimens of femoral head and observed the pathological changes by HE staining,the positive expression of OPG in the femoral head was observed by immunohistochemistry.Result：After the ESWT intervention in 2,4,8 w,the plasma GMP-140 and TM in the group B decreased than the group A（P〈0.05）,while in 4,8 w,the plasma OPG were elevated（P〈0.05）. After the ESWT intervention in 2,4,8 w,as well as the positive expression of OPG in the femoral head compared the group A （P〈0.05）.Conclusion：The ESWT intervention can increase the plasma OPG of the rabbit models,decrease the plasma GMP-140 and TM,enhance the expression of OPG in partial necrosis of femoral head.