医用臭氧对骨关节炎关节软骨作用的病理-磁共振成像实验研究

目的 通过病理-磁共振成像(MRI)对照研究,评价医用臭氧对骨关节炎动物模型的关节软骨的修复作用.方法 新西兰大白兔36只,分为正常对照组、模型对照组、10mg/L臭氧关节腔内注射组、30mg/L臭氧关节腔内注射组、10mg/L臭氧自血回输组、30mg/L臭氧自血回输组,每组6只兔.采用Ⅱ型胶原蛋白酶关节腔内注射法诱导骨关节炎模型,造模4周后进行臭氧干预.比较各组关节软骨的MRI表现,测量其关节软骨的平均厚度及信号强度,与病理学改变对照分析,并对MRI表现与Mankin评分进行直线相关及回归分析.结果 模型对照组、各臭氧干预组的膝关节软骨平均厚度及信号强度较正常对照组变薄和降低(均P<0.05).病理结果显示关节软骨表面粗糙,裂隙形成并基质失染,模型对照及臭氧干预各组的Mankin评分均高于正常对照组(均P<0.05),而模型组与各臭氧干预组间的关节软骨平均厚度、信号强度及Mankin评分差异均无统计学意义(均P>0.05).关节软骨平均厚度与信号强度呈正的直线相关(r=0.561,P=0.000);关节软骨平均厚度及信号强度与Mankin评分呈负的直线相关(r=-0.727、-0.590,均P=0.000);关节软骨平均厚度与Mankin评分存在线性回归关系(Y=18.582-0.035X,R~2=0.528).结论 关节软骨损伤的MRI表现与病理有较好的相关性,中低浓度的医用臭氧经关节腔内注射及自血回输对骨关节炎动物模型的关节软骨可能均无修复作用.

Experimental pathology-MRI study of effects of medical ozone on articular cartilage

Objective To evaluate whether medical ozone has reparative effect on articular cartilage of the osteoarthritis (OA) animal models using a pathology-MRI comparative study. Methods Thirty-six New Zealand rabbits were enrolled and collagenase Ⅱ-induced OA models were established by intra-articular injection in 30 rabbits. The non-model rabbits were then allocated to normal control group and the OA models were randomly divided into the model control group, 10 mg/L ozone intra-articular injection group, 30 mg/L ozone intra-articular injection group, 10 mg/L ozone autohemo-therapy group and 30 mg/L ozone autohemo-therapy group, respectively, with 6 rabbits in each group. Ozone intervention was started from 4 weeks after model establishment. Through MRI study of each group, the mean thickness and signal intensity of articular cartilage were measured and compared with pathology findings. Linear correlation and regression analysis between Mankin score and MRI images were also performed. Results The articular cartilage became thinner and hypointense in animals of model control group and all ozone intervention groups as compared with the normal group (all P<0.05), which were correlated with tough surface, deep tissure and poor staining of the matrix as found in pathology studies. While higher Mankin scores were recorded in model control group and ozone intervention groups as compared to normal control group (all P<0.05). There were no significant differences in mean thickness, signal intensity and Mankin scores of cartilage among each groups of OA rabbits (all P>0.05). The mean thickness and signal intensity showed a positive linear correlation between each other (r=0.561, P=0.000) , in addition, these two parameters showed a negative linear correlation with Mankin score respectively (r=0.727 and -0.590, all P=0.000). A linear regression between mean thickness and Mankin score was demonstrated (Y=18.582-0.035X,R~2=0.528). Conclusions MRI findings of damage to articular cartilage are well correlated with pathology. Either intra-articular injection or autohemotherapy using medium-or low-dose medical ozone may not be effective for repairing the degenerated cartilage in OA.