介入等综合治疗激素性股骨头坏死的实验研究

目的 :探讨药物介入等综合疗法治疗激素性股骨头坏死的作用机制。方法 :将 32只兔子随机分为对照组、模型组、介入组和综合组。于介入前后行血管造影检查 ,并于治疗后 8周 ,分别进行血脂及病理学观察。结果 :介入组和综合组血管中断现象改善 ,终末小血管数目增多。介入组动物总胆固醇、甘油三脂 ,股骨头空骨陷窝率均明显低于模型组 (P<0 0 5 ) ,软骨下区血管数目增多 (P <0 0 1)。综合组与模型组比较 ,甘油三脂明显降低 ,有显著差异 (P <0 0 1) ,与介入组比较亦有差异 (P <0 0 5 ) ;总胆固醇降低 ,与模型组比较仍有差异 (P <0 0 5 ) ;空骨陷窝率较模型组显著降低 (P <0 0 1) ,软骨下区血管数目明显增多 (P <0 0 0 1)。结论 :介入和综合方法治疗股骨头缺血性坏死均有效 ,通过降低血脂 ,改善微循环 ,增加软骨下区血管数目 ,降低骨内压 ,促进坏死骨的修复和新骨再生 ,综合组疗效优于单纯介入治疗组

Expeimental study on the steroid-induced necrosis of femoral head treated by synthetic therapy including intervention

Objective:To study the mechanism of the synthetic therapy treating steroid-induced necrosis of femoral head.Methods:Thirty-two rabbits were randomly divided into 4 groups:control group,model group,intervention group and synthetic group.Angiography was performed before and after intervention.Blood-lipid and pathologic observation was performed 8 weeks after treatment.Results:The blood vessel interruption was improved and the number of ultimate small blood vessels was increased.The total cholesterol,trilyceride and the lacuna rate of empty bones in intervention group were significantly lower than that in model group(P<0.05),but the number of blood vessels in subchondral area was increased.In synthetic group,the trilyceride was significantly lower than that in model group(P<0.01)and the total cholesterol was lower than that in intervention group(P<0.05).Compared with that in model group,the lacuna rate of empty bones in synthetic group was lower(P<0.01)but the number of blood vessels in subchondral area was higher(P<0.001).Conclusion:Both intervention and synthetic therapy have definite therapeutic effects on ischemic necrosis of femoral head by reducing blood-lipid,improving micro-circulation,increasing the blood vessels in subchondral areas,lowering the inner pressure of bone,and promoting the repair of necrotic bones and new bone ostogenesis.The effect in synthetic group is better than that in simple intervention group.