糖尿病引起的股骨头骨代谢变化

目的探讨糖尿病(DM)引起的股骨头骨代谢的病理变化。方法70只成年日本大耳白兔随机分为实验组和对照组。实验组采用四氧嘧啶耳缘静脉快速推入,建立速发型DM动物模型;对照组给予生理盐水注射。在不同时期检测两组动物的组织病理学、血液生化等指标。结果实验组第4周时2只动物出现骨小梁结构紊乱,空缺骨陷窝数增多为14%;第8周时3只动物出现骨小梁结构部分断裂、消失,空缺骨陷窝数增多为28%;第12周时5只动物出现骨小梁结构断裂消失更明显,空缺骨陷窝计数高达56%,透射电镜下骨细胞内出现大小不等的脂滴,骨细胞呈不同程度坏死,骨髓组织增生减低,脂肪细胞增多、增大。与同期对照组比较,实验组第8、12周时血清钙含量下降,血清磷含量增加,差异均有显著性意义(P<0.05,P<0.0l);钙磷乘积12周时低于对照组(P<0.05)。结论DM可引起骨质疏松,当负重时股骨头拱桥结构在机械压力的作用下发生微细骨折,随着DM病程的延长,细微骨折累积,软骨下骨压缩而塌陷,可能压迫骨内微血管引起缺血,这些因素共同作用导致股骨头骨代谢的病理变化。

Changes of Femoral Head Bone Metabolism Induced by Diabetes Mellitus

Objective To explore the pathological changes of the femoral head bone metabolism induced by diabetes mellitus.Methods Seventy rabbits were divided into the control group and experiment group randomly. The control group were injected with saline; while the experiment group were injected with Alloxan through ear-edge vein quickly to establish the immediate diabetes mellitus model. The histopathology, ultrastructure, biochemistry, hemorrheology, and platelet function of all animals of two groups were detected in different periods.Results In the experiment group, 2 animals' bone trabecula were found disorder and vacant bone lacuna was 14% in the 4th week; in the 8th week, 3 animals' part bone trabecula were found breakage, defluxion, vacant bone lacuna was 28%; in the 12th week, 5 animals' bone trabecula were found breakage, defluxion obviously, vacant bone lacuna was 56%. Under TEM, there was some lipid droplet in bone cells, bone cellular necrotized at different levels. Myelosis decrease, the number and diameter of adipose cell increased. In the 8th and 12th week, the content of serum calcium decreased and that of serum phosphorus increased in the experiment group compared with the control group ( P<0.05, P<0.0l), and the product of calcium and phosphorus of the experiment group in the 12th week was lower than that of the control group (P<0.05).Conclusion DM can cause osteoporosis. Capillary fracture happens in the arch bridge structure of femoral head under machine press while being pressed. Along with the course of DM process, capillary fracture accumulates, bone under cartilage compress and collapse. It can oppress bone capillary to cause ischemia. All factors result in the basic pathology and the primary pathogenesy of the femoral head.