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| 99Tc-MDP治疗与骨修复的试验研究 |
| Experimental study of the99Tc-MDP therapy on bone repairing |
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| DOI：10.3969/j.issn.1006.7108.2015.07.014 |
| 中文关键词: 股骨头无菌性坏死 99Tc-MDP 治疗 |
| 英文关键词:ANFH 99 Tc-MDP Therapy |
| 基金项目:上海市卫生局中医药科研基金（2012J015A) |
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| 中文摘要: |
| 目的 药物99Tc-MDP治疗对股骨头无菌性坏死(ANFH)的修复价值研究。方法 动物试验分为二个阶段:制作模型阶段和治疗观察阶段。采用肌肉注射地塞米松磷酸钠注射液制作ANFH动物模型，第一阶段设：正常组（A组）、ANFH模型组 (B组），时间为8周。在病理细胞学、骨密度、骨形态计量检测、四环素双标记试验、核素骨骼显像感兴趣区（ROI)比值、X线摄片、CT摄片等试验证实ANFH动物模型成立后再进行第二阶段试验。第二阶段设:正常对照组（C组）、ANFH模型对照组 (D组）、99Tc-MDP治疗组(E组）、阿仑膦酸钠治疗组(F组），并进行99Tc-MDP和“阿仑膦酸钠”治疗，疗程为16周，行与第一阶段相同的各项检测。并对E组、F组的疗效进行评判。采用SPSS13.0软件统计数据。结果 第一阶段结束，A组、B组的病理切片结果显示：A组股骨头无骨组织破坏;而B组表现为：股骨头关节表面软骨破坏，骨小梁稀疏、断裂，空骨陷窝数增多等破坏现象。B组的骨密度、骨形态计量、四环素双标记试验骨转换值明显降低（P <0.01)，核素“99mTc -MDP”骨骼显像 ROI比值、血清BALP、BGP检测结果明显高于(P <0. 05)，X线摄片、CT摄片见B组的股骨头存在稀疏现象，显示ANFH模型成立。经过对E组、F组进行治疗16周后，各项检测指标结果显示，A组、C组与B组、D组试验结果基本相似。E组、F组均有所改善，以E组骨修复更明显，骨小梁增粗，空骨陷窝消失，各项检测指标接近于C组。结论 动物试验显示，99Tc-MDP治疗动物ANFH疗效明显，不仅具有“阿仑膦酸钠”的双膦酸盐治疗作用，对ANFH治疗后的四环素双标记试验及骨小梁增粗， 空骨陷窝消失现象显示，可能存在相对的促进成骨细胞功能和加快损伤骨的骨修复价值。 |
| 英文摘要: |
| Objective To study the therapeutic value of99 Tc-MDP for bone repairing in aseptic necrosis of the femoral head (ANFH). Methods The animal experiment included 2 stages ：the establishment of animal model and the treatment observation. ANFH animal model was made by dexamethasone intramuscular injection. Intramuscular injection of dexamethasone was used to establish the ANFH model. In the first stage of 8 weeks，normal group (Group A) and ANFH model group (Group B) were set up. The successful animal model was proved by cell pathology， bone morphology，BMD， tetracycline double labeling， bone scintigraphy ROI value，X-ay，and CT. In the second stage of 16 weeks，normal control group (Group C)，ANFH model control Group (Group D)，99 Tc-MDP therapy Group (Group E)，and alendronate sodium therapy group (Group F) were set up. The same tests were applied like in stage 1 and the efficacy in Group E and Group F was valued. SPSS13 was used for statistical analysis. Results At the end of stage 1，the pathology showed that no bone tissue was destroyed in Group A，but in Group B the surface soft tissue of the femoral head was destroyed，and bone trabecular breaking and bone lacuna increased. BMD，bone histomorphology，tetracycline double labeling decreased and bone scintigraphy ROI，serum BALP and BGP increased in Group B. ANFH could be seen by X ray and CT in Group B. After 16-week therapy in Group E and Group F，all the test results showed a nearly same results between Group A，C and Group B，D. Improved result showed in Group E and Group F，especially in Group E for bone repairing，bone trabecular increasing，and bone lacuna disappearing. All the results were comparable between Group E and Group C. Conclusion Animal study shows an apparent result of99 Tc-MDP treatment for ANFH.99 Tc-MDP not only has the same function like alendronate sodium showing increased bone trabeculae in tetracycline double labeling test. but also reveals the potential function in promoting osteoblast function and bone tissue repairing indicated by bone lacuna disappearing. |
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