联合用药对激素性股骨头坏死干预作用的实验研究

目的探讨密盖息联合藻酸双酯钠（PSS）对兔早期激素性股骨头坏死的防治作用。方法健康成年普通级大白兔30只,喂养条件相同。随机分为五组（A、B、C、D、E组）,每组6只,实验持续6周。观察各组动物的大体情况,各组得6个股骨头,HE染色切片于普通光镜下观察股骨头组织结构变化并做形态计量学测量,骨密度仪测量股骨头骨密度。结果 B组空骨陷窝率显著高于其他组（P〈0.01）;E组中平均骨小梁面积、骨小梁密度显著高于A、B、C组（P〈0.05）;脂肪细胞面积比E组低于B、D组（P〈0.05）;并且E组与A组组织学显示髓内脂肪细胞堆积少,造血细胞多见,骨小梁结构正常,空骨陷窝少。结论①单用PSS治疗能有效减轻糖皮质激素所致的脂质代谢紊乱,但不能有效预防骨质疏松;单用密盖息能有效预防激素性骨质疏松,但对于减轻脂质代谢紊乱无明显效果;②PSS联合密盖息既可以减少髓内脂肪堆积,又能够增加骨密度改善骨组织结构,对早期激素性股骨头坏死有很好的干预作用。

Experimental study of drugs combination in intervention of hormonal necrosis of femoral head

Objective To study the preventive effects of miacalcic associate with PSS on the glucocorticoid induced nec rosis of femoral head in rabbits. Methods Thirty common grade adult rabbits were randomly divided into 5 groups, namely groups A, B, C, D ,E. In group A ,6 rabbits received no injections and served as the control group. All animals were sacri ficed at intervals between 3 and 6 weeks. Then the histopathological changes of the femoral head of rabbits were observed under light microscopy and made morphometry measurements; The bone mineral density of the femoral head was meas ured. Results In group B, the rate of empty lacunae was significantly higher than other groups （P 〈 0. 01 ） ; In group E, the mean trabecular area and the trabeenlar bone density were significantly higher than A, B, C group （ P 〈 O. 05 ） ; The ra tio of fat cells in group E was lower than B,D group （P 〈 0. 05） ;The histology of group E and group A showed less accu mulation of fat cells, more hematopoietic cells in intramedullary, normal trabecular structure, and less empty bone lacu nae. Conclusions （~）PSS therapy alone can effectively reduce lipid metabolic disorder, but it can not effectively prevent osteoporosis ; Miacalcic alone can effectively increase bone density and prevent osteoporosis, however,the role to reduce lip id metabolic disorder was not obvious;（）Two drugs in combination can not only reduce lipid metabolic disorder, but also in crease bone mineral density to improve the organizational structure and prevent osteoporosis. The two drugs play an impor tant role in early prevention of GANFH.