發(fā)布時間：2018-08-14 09:23

【摘要】：背景:激素性股骨頭壞死是非創(chuàng)傷性股骨頭壞死中最常見的病因之一,目前尚沒有有效的手段來預防和治療激素性股骨頭壞死。已經(jīng)有動物體內(nèi)實驗研究證明低強度脈沖超聲可在一定程度上抑制激素性股骨頭壞死的進展。我們在超聲干預的過程中加入微泡來驗證微泡聯(lián)合低強度脈沖超聲是否可提高單純超聲干預對激素性股骨頭壞死的抑制作用。方法:兔子激素性股骨頭壞死的模型是通過一次低劑量內(nèi)毒素聯(lián)合多次大劑量甲強龍注射來建立的。24只雄性新西蘭兔子(隨機平均分為三組,對照組(造模后不作治療),超聲組(造模后低強度脈沖超聲治療)和微泡超聲組(造模后微泡局部注射聯(lián)合低強度脈沖超聲治療)。低強度脈沖超聲的強度為200mW/cm2,每天治療20分鐘,共治療6周。6周后獲取雙側股骨頭標本行micro-CT,生物力學,實時定量PCR,western blot,組織學和免疫組織化學等檢測。結果:經(jīng)過6周的干預后,對照組中,骨密度,骨小梁數(shù)量,抗壓載荷和骨礦化率等顯著降低,表明我們的選模是成功的。微泡組中,骨密度值較超聲組顯著增高(932.6 ± 6.861 mg/cm2 vs.894.5 ± 12.84 mg/cm2),具有統(tǒng)計學差異(p0.001)。微泡組中,骨小梁數(shù)量較超聲組顯著增多(2.352 ± 0.06980/mm vs.2.213 ±0.07245/mm),具有統(tǒng)計學差異(p0.001)。骨小梁厚度在微泡組中較超聲組有所增厚,但無統(tǒng)計學差異(p=0.286)。微泡組中,骨礦化率顯著高于超聲組(2.660±0.2390μm/dayvs.1.913 ± 0.1457μm/day),具有統(tǒng)計學差異(p=0.008)。微泡組最大抗壓載荷值顯著高于超聲組(467.2 ± 65.96N vs.365.6 ±57.40N),且差異有統(tǒng)計學意義(P0.001)微泡超聲顯著增強了 FHN骨組織中VEGF和BMP-2的表達。微泡組血管數(shù)量明顯多于超聲組(13.7±4.3/mm2vs.8.3±1.6/mm2),差異有統(tǒng)計學意義(p=0.041)。微泡組的血管最小直徑大于超聲組(28.6 ± 4.6μm vs.23.9 ± 4.2μm),但是差異沒有統(tǒng)計學意義(p=0.205)。結論:我們的研究結果證實,相比單純使用低強度脈沖超聲,微泡超聲對激素性股骨頭壞死進展的抑制作用更強。
[Abstract]:Background: hormonal necrosis of the femoral head is one of the most common causes of nontraumatic osteonecrosis of the femoral head. In vivo experiments have shown that low-intensity pulsed ultrasound can inhibit the progress of hormone-induced femoral head necrosis to some extent. We added microbubbles in the process of ultrasound intervention to verify whether microbubbles combined with low-intensity pulsed ultrasound could increase the inhibitory effect of ultrasound alone on steroid-induced femoral head necrosis. Methods: the model of steroid-induced femoral head necrosis in rabbits was established by a low dose endotoxin injection combined with a large dose of methylenolone injection. 24 male New Zealand rabbits were randomly divided into three groups. Control group (no treatment after modeling), ultrasound group (low intensity pulsed ultrasound treatment after model making) and microbubble ultrasound group (local injection of microbubble combined with low intensity pulsed ultrasound treatment). The intensity of low-intensity pulsed ultrasound was 200mW / cm ~ 2. After 6 weeks of treatment, micro-CTS, biomechanics, real-time quantitative PCRX Western blot, histology and immunohistochemistry were performed. Results: after 6 weeks of intervention, bone mineral density, bone trabecula number, compressive load and bone mineralization rate were significantly decreased in the control group, indicating that our model selection was successful. The BMD in the microbubble group was significantly higher than that in the ultrasound group (932.6 鹵6.861 mg/cm2 vs.894.5 鹵12.84 mg/cm2). The number of bone trabeculae in microbubble group was significantly higher than that in ultrasound group (2.352 鹵0.06980/mm vs.2.213 鹵0.07245/mm). The thickness of trabecular bone in microbubble group was thicker than that in ultrasound group, but there was no statistical difference (p0. 286). The bone mineralization rate in the microbubble group was significantly higher than that in the ultrasound group (2.660 鹵0.2390 渭 m/dayvs.1.913 鹵0.1457 渭 m/day). The maximum compressive load in the microbubble group was significantly higher than that in the ultrasound group (467.2 鹵65.96N vs.365.6 鹵57.40N), and the difference was statistically significant (P0.001). The expression of VEGF and BMP-2 in the bone tissue of FHN was significantly enhanced by microbubble ultrasound. The number of blood vessels in the microbubble group was significantly higher than that in the ultrasound group (13. 7 鹵4.3/mm2vs.8.3 鹵1.6/mm2), and the difference was statistically significant (p0. 041). The minimum diameter of blood vessel in the microbubble group was larger than that in the ultrasound group (28.6 鹵4.6 渭 m vs.23.9 鹵4.2 渭 m), but the difference was not statistically significant (p0. 205). Conclusion: our results confirm that microbubble ultrasound can inhibit the progression of steroid-induced osteonecrosis of femoral head more strongly than using low intensity pulsed ultrasound alone.
【學位授予單位】：浙江大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R681.8

【相似文獻】

相關期刊論文 前10條

1 ;科學家發(fā)現(xiàn)細胞微泡可以診斷癌癥[J];廣西科學;2008年04期

2 游向東,周穎,單江,劉伊麗;蛋白微泡聲學造影劑在缺血再灌注心肌中排空現(xiàn)象及其機制的探討[J];中華超聲影像學雜志;2003年06期

3 李彬,萬明習,王素品;納米包膜造影微泡在脈沖超聲場中的瞬態(tài)非線性特性研究[J];聲學學報;2004年06期

4 張群霞,王志剛,冉海濤,李曉東,鄭元義,景香香;不同超聲強度及微泡對基因和組織作用的實驗研究[J];中華超聲影像學雜志;2005年04期

5 張虎,王宏宇;微泡和超聲 從診斷到治療[J];中國民康醫(yī)學;2005年08期

6 魏倕;謝志行;;帶球殼微泡和空化氣泡的超聲特性研究[J];聲學技術;2007年03期

7 楊莉;劉政;左松;譚開彬;高云華;付赤學;李秋穎;;脂膜微泡結合凝血酶原復合物的制備[J];中國醫(yī)學影像學雜志;2007年05期

8 劉學兵;王志剛;許川山;夏新蜀;張勇;李攀;冉海濤;譚勇;;一種新型載光敏劑的微泡制備及其基本物理特性研究[J];激光雜志;2008年05期

9 朱蔚;周翔;羅燕;彭玉蘭;田野;王冬梅;柳曉軍;李珂;莊華;解慧琪;;“流動的肺泡?”——超聲諧振微泡定向增加組織局部供氧的理論研究[J];中國醫(yī)學影像技術;2012年10期

10 李彬,萬明習;納米包膜造影微泡的小波檢測技術研究[J];聲學學報;2005年05期

相關會議論文 前10條

1 柳建華;蕭淑宜;何景光;區(qū)文財;邱春花;馮桂英;;微泡聯(lián)合低強度治療超聲對犬睪丸組織及細胞影響的研究[A];中國超聲醫(yī)學工程學會第九屆全國腹部超聲醫(yī)學學術會議論文匯編[C];2012年

2 張群霞;王志剛;冉海濤;李曉東;鄭元義;景香香;;不同超聲強度及微泡對基因和組織作用的實驗研究[A];第九屆全國超聲醫(yī)學學術會議論文匯編[C];2006年

3 姜學平;程茜;錢夢，

本文編號：2182415