本文選題：骨質(zhì)疏松 + 骨關(guān)節(jié)炎�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:分別制備大鼠骨質(zhì)疏松和骨關(guān)節(jié)炎模型。方法:8周齡雌性SD大鼠32只,分為4組:A組(假去勢(shì)組),B組(OP組);C組(假關(guān)節(jié)炎組),D組(OA組)。B組大鼠去勢(shì),術(shù)后12周時(shí)通過(guò)雙能X線骨密度儀測(cè)定腰椎和股骨的BMD以及通過(guò)三點(diǎn)彎曲試驗(yàn)觀察股骨力學(xué)特性。D組行改良Hulth法,4周時(shí)通過(guò)關(guān)節(jié)大體變化和組織切片來(lái)驗(yàn)證骨關(guān)節(jié)炎模型。結(jié)果:對(duì)于A組和B組:去勢(shì)12周后,B組大鼠腰椎和股骨的BMD都低于A組且有統(tǒng)計(jì)學(xué)差別(P0.05);B組大鼠股骨承受的最大應(yīng)力明顯下降(P0.05)。對(duì)于C組和D組:術(shù)后4周,相比C組,D組關(guān)節(jié)周圍滑膜腫脹以及軟骨表面明顯退變;HE染色切片也顯示:D組軟骨結(jié)構(gòu)和細(xì)胞損傷嚴(yán)重,Mankin評(píng)分明顯高于C組(P0.05)。結(jié)論:通過(guò)去勢(shì)法12周是成功制備大鼠OP模型的有效方法,通過(guò)改良Hulth法(ACL+MM)4周可以成功制備骨關(guān)節(jié)炎模型。目的:ESWT對(duì)伴骨質(zhì)疏松的骨關(guān)節(jié)炎模型軟骨及軟骨下骨結(jié)構(gòu)、代謝及功能的影響。方法:8周齡雌性SD大鼠36只,分為3組:Sham組,OPOA組,ESWT組。OPOA組和ESWT組均去勢(shì),在12周驗(yàn)證骨質(zhì)疏松模型后,通過(guò)改良Hulth法制備骨關(guān)節(jié)炎模型。改良Hulth法術(shù)后1周,ESWT組開始在軟骨下骨部位給予ESW干預(yù),1周1次,共4次(能量1.6bar,脈沖1000次,頻率為5Hz)。干預(yù)4周后通過(guò)組織形態(tài)學(xué)和生物力學(xué)來(lái)觀察關(guān)節(jié)軟骨的變化;通過(guò)Micro-CT和免疫組化來(lái)觀察軟骨下骨的微結(jié)構(gòu)變化;通過(guò)步態(tài)分析來(lái)觀察大鼠的功能變化。結(jié)果:相比Sham組,OPOA組的關(guān)節(jié)周圍滑膜增生,軟骨表面可見裂紋,且Mankin和toluidine blue評(píng)分顯著提高。而ESWT組較OPOA組軟骨退變有所改善,Mankin也明顯降低。生物力學(xué)顯示:OPOA組的應(yīng)力應(yīng)變曲線位移和蠕變顯著性增加相對(duì)于sham組,經(jīng)ESW干預(yù)4周后,可見關(guān)節(jié)軟骨的力學(xué)特性有所恢復(fù),應(yīng)力應(yīng)變曲線位移(除了0.02N)和蠕變顯著性下降。Micro-CT結(jié)果顯示:OPOA組軟骨下骨微結(jié)構(gòu)明顯破壞,BV/TV、Tb.N和Tb.Th都明顯減少而Tb.Sp明顯增加,ESW干預(yù)4周后,BV/TV、Tb.N和Tb.Th都明顯增加而Tb.Sp顯著性下降。免疫組化顯示:OPOA組BMP-2和Osterix蛋白表達(dá)明顯減少相對(duì)于Sham組。經(jīng)ESW治療后,BMP-2和Osterix表達(dá)都顯著性增加。步態(tài)分析結(jié)果顯示:相對(duì)于Sham組,OPOA組支撐時(shí)相(stance phase),擺動(dòng)速度(swing speed),和單足支撐時(shí)相(single stance phase)顯著性縮短。在ESW干預(yù)4周后,大鼠步態(tài)狀態(tài)有一定的改善,ESWT組支撐時(shí)相(stance phase),擺動(dòng)速度(swing speed)和單足支撐時(shí)相(single stance phase)顯著性變長(zhǎng),同時(shí)擺動(dòng)時(shí)相(swing phase)顯著性縮短。結(jié)論:ESW通過(guò)干預(yù)軟骨下骨,既延緩和阻止了OPOA大鼠關(guān)節(jié)軟骨的退變,也從步態(tài)方面改善了大鼠的運(yùn)動(dòng)功能。
[Abstract]:Objective: to establish rat models of osteoporosis and osteoarthritis.Methods Thirty-two female Sprague-Dawley rats (8 weeks old) were divided into 4 groups: group A (sham ovariectomized group), group B (group B) and group C (group C).BMD of lumbar vertebrae and femur was measured by dual energy X-ray absorptiometry 12 weeks after operation. The mechanical properties of femur in group D were observed by three point bending test. The model of osteoarthritis was verified by gross changes and tissue sections in group D after 4 weeks with modified Hulth method.Results: for group A and group B, the BMD of lumbar vertebrae and femur in group B was lower than that in group A after 12 weeks of castration, and there was significant difference in the maximum stress of femur in group B (P 0.05).For group C and group D: 4 weeks after operation, compared with group C, the swelling of synovium around the joint and the obvious degeneration of cartilage surface in group C and HE staining also showed that the Mankin score of cartilage structure and cell damage in group D was significantly higher than that in group C (P 0.05).Conclusion: the ovariectomized 12 weeks method is an effective method for the successful establishment of rat op model, and the modified Hulth method can be used to establish the osteoarthritis model by using the modified ACL MM)4 week.Objective to study the effects of ESWT on the structure, metabolism and function of cartilage and subchondral bone in osteoarthritis model with osteoporosis.Methods Thirty-six female Sprague-Dawley rats (8 weeks old) were divided into 3 groups: OPOA group, ESWT group, OPOA group and ESWT group. Osteoarthritis model was established by modified Hulth method after the osteoporosis model was verified at 12 weeks.One week after modified Hulth, ESW intervention was given to the subchondral bone once a week for 4 times (energy 1.6 bar. pulse 1000, frequency 5 Hz).After 4 weeks of intervention, the changes of articular cartilage were observed by histomorphology and biomechanics, the changes of microstructures of subchondral bone were observed by Micro-CT and immunohistochemistry, and the functional changes of rats were observed by gait analysis.Results: compared with Sham group, periarticular synovial hyperplasia and cartilage surface cracks were observed, and the scores of Mankin and toluidine blue were significantly improved.The cartilage degeneration in ESWT group was significantly lower than that in OPOA group.Biomechanics showed that the stress-strain curve displacement and creep of the sham group increased significantly compared with that of the sham group. After 4 weeks of ESW intervention, the mechanical properties of articular cartilage recovered.The results of stress-strain curve displacement (except 0.02N) and significant decrease of creep. Micro-CT results showed that the microstructures of subchondral bone in the group of w / w OPOA significantly destroyed BV / TVT Tb.N and Tb.Th, while Tb.Sp significantly increased the number of BV / TVTV-Tb.N and Tb.Th, while Tb.Sp decreased significantly after 4 weeks of intervention.Immunohistochemical staining showed that the expression of BMP-2 and Osterix protein decreased significantly in OPOA group compared with Sham group.After ESW treatment, the expression of BMP-2 and Osterix increased significantly.The results of gait analysis showed that the swing speed and single stance phase of Sham group were significantly shorter than those of Sham group.After the intervention of ESW for 4 weeks, the gait state of rats was improved to some extent. In ESWT group, the phase of stance phase (swing speed) and the phase of single stance phase at one foot support increased significantly, and the phase of swing phase of ESWT group was shortened significantly.Conclusion by interfering with the subchondral bone, the OPOA can not only delay and prevent the degeneration of articular cartilage, but also improve the motor function in gait.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R580;R684.3;R-332

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本文編號(hào)：1760231