本文選題：激素性股骨頭壞死 + TGF-β1　； 參考：《廣州中醫(yī)藥大學》2014年碩士論文

【摘要】：目的： 觀察人和兔激素性股骨頭壞死的骨組織中生長轉化因子-β1(Transforming Growth Factor-β1, TGF-β1)、金屬基質蛋白-2(matrix metall oproteinase-2, MMP-2)、Run相關轉錄因子2(Runt-related transcription factor2, RunX2)-.骨鈣素(Bone gamma-carboxyglutamic-acid-containing proteins, BGP)的表達情況,探討其在激素性骨壞死修復中的作用機制。 方法： (1)動物實驗：健康普通級新西蘭家兔20只按完全隨機分原則成兩大組(實驗組10只,對照組10只),實驗組于耳緣靜脈注射大腸桿菌內(nèi)毒素12.5μg/kg,24h后重復給藥1次,注射完畢后,立即臀肌注射甲基潑尼松龍40mg/kg共3次,每次間隔24h。對照組與實驗組相同時間點注射等量生理鹽水。末次注射注射用甲潑尼龍琥珀酸鈉2個月后,兩組兔子行X線片、MRI檢查。影像學檢查后予過度麻醉處死20只兔子,將兔股骨頭標本行固定、脫鈣,系列脫水后石蠟包埋石蠟制成切片及HE染色,對標本進行病理檢查,最后采用免疫組織化學檢測兔股骨頭骨組織中TGF-β1、 MMP-2、骨鈣素表達水平,采用QPCR檢測兔股骨頭骨組織中Run-X2信號的表達水平。 (2)臨床研究：2013年10月至2014年2月,收集在廣州中醫(yī)藥大學第一附屬醫(yī)院三骨科住院的14例需要行全髖關節(jié)置換術病例(其中實驗組7例全為激素性股骨頭壞死ARCOIV期的患者,對照組7例來源為股骨頸骨折、髖關節(jié)發(fā)育不良、骨性關節(jié)炎的患者),術后將14例股骨頭標本行固定、脫鈣,系列脫水后石蠟包埋石蠟制成切片以及HE染色,對標本進行病理檢查,最后采用免疫組織化學檢測兔股骨頭骨組織中TGF-β1、MMP-2、骨鈣素表達水平,采用QPCR檢測兔股骨頭骨組織中Run-X2信號的表達水平。 結果： 1.動物實驗研究：兔實驗組X線片檢查、MRI檢查以及病理檢查均示股骨頭壞死,對照組X線片檢查、MRI檢查以及病理檢查均無股骨頭壞死征象。免疫組織化學檢測兔實驗組股骨頭骨組織中TGF-β1、MMP-2、骨鈣素的表達結果較對照組低,差異均具有統(tǒng)計學意義(P0.05)；QPCR檢測兔實驗組股骨頭骨組織中Run-X2信號的表達結果較對照組低,差異均具有統(tǒng)計學意義(P0.05) 2.臨床研究：人實驗組病理檢查均顯示有股骨頭壞死,對照組均未發(fā)現(xiàn)股骨頭壞死征象。免疫組織化學檢測人試驗組股骨頭骨組織中TGF-β1、MMP-2、骨鈣素的表達結果較對照組低,差異均具有統(tǒng)計學意義(P0.05); QPCR檢測人試驗組股骨頭骨組織中Run-X2信號的表達結果較對照組低,差異均具有統(tǒng)計學意義(P0.05)。 結論： 激素性股骨頭壞死的機制可能與股骨頭骨組織中的TGF-β1、MMP-2、RunX2、骨鈣素表達水平過低有關。
[Abstract]:Objective: Growth factor-尾 1(Transforming Growth factor- 尾 1, TGF- 尾 1, metallomatrix protein-2 matrix metall oproteinase-2, MMP-2run related transcription factor 2(Runt-related transcription factor 2, RunX 2 -, were observed in human and rabbit osteonecrosis of femoral head. The expression of osteocalcin gamma-carboxyglutamic-acid-containing proteins (BGP) and its role in the repair of steroid-induced osteonecrosis were investigated. Methods: (1) Animal experiment: 20 healthy New Zealand rabbits of general grade were randomly divided into two groups (10 in the experimental group and 10 in the control group). In the experimental group, E. coli endotoxin 12.5 渭 g / kg / kg was injected intravenously at the ear edge for 24 hours. Methylprednisolone 40mg/kg was injected immediately into gluteus muscle for 3 times with 24 h interval. The control group and the experimental group were injected with the same amount of saline at the same time. Two months after the last injection of methylprednisolone sodium succinate, two groups of rabbits were examined by X-ray and MRI. After imaging examination, 20 rabbits were killed under excessive anesthesia. The femoral head of rabbits were fixed, decalcified, paraffin embedded in paraffin after serial dehydration and stained with HE. The specimens were examined by pathology. Finally, the expression of TGF- 尾 _ 1, MMP-2 and osteocalcin in rabbit femoral head was detected by immunohistochemistry, and the expression of Run-X2 signal was detected by QPCR. (2) Clinical study: from October 2013 to February 2014, 14 patients who were hospitalized in the Department of Orthopaedics, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, required total hip arthroplasty (7 of them in the experimental group were all ARCOIV patients with steroid-induced femoral head necrosis). The control group included 7 patients with femoral neck fracture, hip dysplasia and osteoarthritis. After operation, 14 femoral head specimens were fixed, decalcified, paraffin embedded in series of dehydrated paraffin sections and stained with HE. The expression of TGF- 尾 _ 1 and MMP-2 and osteocalcin in rabbit femoral head were detected by immunohistochemistry, and the expression of Run-X2 signal in femoral head was detected by QPCR. Results: 1. Animal experimental study: in the experimental group, MRI and pathological examination showed necrosis of femoral head, while in the control group, there were no signs of necrosis of femoral head on MRI and pathological examination. The expression of TGF- 尾 1 and MMP-2 and osteocalcin in the femoral head of the experimental group were detected by immunohistochemistry. The difference was statistically significant (P 0.05). The expression of Run-X2 signal in the femoral head of the experimental group was lower than that in the control group. The difference was statistically significant (P0.05). 2. Clinical study: femoral head necrosis was found in human experimental group and no sign of femoral head necrosis was found in control group. The expression of TGF- 尾 1 and MMP-2 and osteocalcin in femoral head of human experimental group were detected by immunohistochemistry, the difference was statistically significant (P 0.05), and the expression of Run-X2 signal in bone tissue of human experimental group was lower than that of control group. The difference was statistically significant (P 0.05). Conclusion: The mechanism of steroid-induced osteonecrosis may be related to the low expression of TGF- 尾 _ 1, MMP-2MMP _ 2, and osteocalcin in femoral head.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R681.8

【參考文獻】

相關期刊論文 前10條

1 鄭麗芳;梅元武;張小喬;張紅;楊揚;;TGF-β1對MSCs體外模擬缺血性損傷的保護作用[J];青島大學醫(yī)學院學報;2008年06期

2 嚴芳;王捷;;骨重建中樞調(diào)控機制研究進展[J];廣東醫(yī)學;2009年02期

3 王艾麗;陳玲玲;胡劍峰;程新耀;;TGF-β_1對骨髓間充質干細胞在無氧無血清條件下凋亡的影響[J];武漢大學學報(醫(yī)學版);2007年06期

4 鄭曉輝,方秀斌;骨鈣素的基礎與應用研究進展[J];解剖科學進展;1999年04期

5 何偉，，袁浩，蔡振基，樊粵光;中西醫(yī)結合治療股骨頭缺血性壞死[J];新中醫(yī);1995年08期

6 王智興，夏筠，楊慶銘;成年家兔去卵巢后血清骨鈣素及多種磷酸酶的變化[J];上海第二醫(yī)科大學學報;1996年06期

7 齊振熙;康靖東;李樹強;;活血化瘀中藥對激素性股骨頭缺血壞死模鼠TGF-β_1表達的實驗研究[J];中國骨傷;2009年08期

8 李雄,袁浩;袁浩教授對股骨頭壞死中醫(yī)藥論治的學術思想[J];中國中醫(yī)骨傷科;1999年01期

9 楊志明,余希杰,解慧琪,陳旭,屈藝;不同來源成骨細胞生物學特性的比較研究[J];中華創(chuàng)傷雜志;2001年01期

10 ;Dexamethasone-induced adipogenesis in primary marrow stromal cell cultures: mechanism of steroid-induced osteonecrosis[J];Chinese Medical Journal;2006年07期

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