股骨头骨骺缺血性坏死模型兔构建及组织病理学变化和p53与bcl-2的表达

背景：研究表明儿童股骨头骨骺缺血性坏死(Perthes病)的发病与儿童股骨头血液供应、髋关节周围病变、外伤、内分泌因素、遗传等多种原因有关。 目的：建立可靠的Perthes病的动物模型，并观察其股骨头组织学变化、细胞凋亡情况及p53和bcl-2基因的表达，并探讨凋亡基因p53和bcl-2与Perthes病的的相关性。 方法：采用C型臂透视下经右侧股骨颈注射TH胶致骺板缺血，建立幼兔Perthes病模型，并以同样方法用经右侧股骨颈给予注射生理盐水的兔作对照，于建模后4，6，8，10，12周分别取模型组和对照组两组右侧股骨头做病理切片，观察两组髋关节骺板细胞凋亡情况，并观察两组右侧股骨头p53和bcl-2等凋亡基因表达阳性率的变化。 结果与结论：建模后4周开始出现模型组右侧髋关节关节间隙增宽，出现点状出血变性区并逐步扩大，随后关节软骨与骨骺的黏附强度下降，骨质松脆，干骺端疏松变软。模型组右侧股骨头骺板细胞凋亡率与p53基因表达阳性率呈明显正相关性(r =0.68, P < 0.05)，与bcl-2基因表达阳性率之间呈明显负相关性(r =-0.75, P < 0.01)。实验建立的perthes病动物模型稳定，简单，无反复现象。结果证实了Perthes病的发生与p53和bcl-2凋亡基因相关。

Histopathological changes and p53, bcl-2 expression in rabbit femoral head Perthes models

BACKGROUND:Morbidity of Perthes disease is associated with femoral head blood supply, periacetabular lesion, surgical trauma, endocrine, as well as heredity in children.  OBJECTIVE:To construct a animal model of perthes disease and to observe the histopathological change, apoptosis and p53 and bcl-2 gene expression, and to explore the correlation between p53 and bcl-2 gene and pathogenesis of Perthes disease. METHODS:New Zealand neonatal rabbits were constructed Perthes disease models by injecting TH glum into right femoral head under C-type arm, normal saline was injected in the control group. At 4, 6, 8, 10 and 12 weeks after modeling, right femoral head of rabbits were prepared for pathological sections, and the apoptosis of epiphyseal plate cells, the changes of p53 and bcl-2 gene expression were observed.  RESULTS AND CONCLUSION:At 4 weeks after modling, the joint space became widen in the right femoral head, presented with punctate hemorrhage and denaturization, followed by declines in the adhearant density and sclerotin crispness, the metaphysic softened and loosened. There was a positive correlation between epiphyseal plate cell apoptosis p53 gene expression in the model group (r = 0.68, P < 0.05)and negative correlation between epiphyseal plate cell apoptosis and Bcl-2 gene expression (r = -0.75, P < 0.01). The constrcuted models are characterized by stablity, simple manipulation and reproducibility. The findings demonstrated that p53 and bcl-2 apoptotic gene have correlation with pathogenesis of Perthes disease.