本文關(guān)鍵詞： 骨壞死 骨質(zhì)疏松 病理 相關(guān)性　出處：《遵義醫(yī)學(xué)院》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的：建立骨質(zhì)疏松和骨壞死的大白兔模型,比較骨壞死與骨質(zhì)疏松病理學(xué)變化的異同點(diǎn),進(jìn)一步探討骨質(zhì)疏松與骨壞死兩者的相互關(guān)系及相關(guān)機(jī)制。方法：取32只3月齡雌性新西蘭大白兔,隨機(jī)分成4組即A組(肌注激素組,8只。)B組(去勢(shì)組,8只。)C組(去勢(shì)+肌注激素組,8只。)D組(空白對(duì)照組：假手術(shù)+肌注生理鹽水組,8只。)B、C兩組動(dòng)物取下腹部正中切口,完整切除雙側(cè)卵巢,A、D兩組除未行卵巢結(jié)扎切除外,其余步驟同B、C兩組。術(shù)中甲硝唑沖洗腹腔,術(shù)后所有動(dòng)物每周臀肌注射一次青霉素10萬U/kg。手術(shù)1周后A、C兩組動(dòng)物予臀肌注射氫化可的松7.5mg/kg,每周兩次,B、D兩組動(dòng)物予等量生理鹽水臀肌注射。分別在給藥后5周、10周后行骨密度(BMD)檢測(cè),并處死4只,取雙側(cè)股骨頭,行HE染色、油紅O染色及掃描電鏡檢測(cè)。結(jié)果：A組、B組和C組在術(shù)后5周腰椎BMD(單位mg/cm2)較術(shù)前(246±19 vs 269±13、256±22 vs 269±13、236±22 vs 273±16)及D組同時(shí)期(272±19)均減低,術(shù)后10周腰椎BMD較術(shù)前(221±13 vs 269±13、222±18 vs 269±13、185±11 vs 273±16)及D組同時(shí)期(263±23)均明顯減低(P0.05)。A組、B組和C組術(shù)后5W股骨近端BMD較術(shù)前(256±20 vs 306±24、264±20 vs 306±21、236±46 vs 301±22)及D組同時(shí)期(305+23)均減低,術(shù)后10周股骨近端BMD(230±22 vs 306±24、230±17 vs 306±21、189±39 vs 301±22)及D組同時(shí)期(297±28)均明顯減低(P0.05)。但只有C組術(shù)后10周的BMD小于術(shù)前及D組同時(shí)期BMD均值減去2.0SD(P0.05)。造模后5周,A、B、C三組空骨陷窩陽性率(%)較D組明顯增高(15.20±1.09、14.13±1.05、18.53±0.67 vs10.40±0.97,P0.05)。A、B、C三組骨小梁可見不同程度的稀疏,部分?jǐn)嗔�。造模�?0周,A、B、C三組空骨陷窩陽性率較D組明顯增高(22.43±0.78、21.20±1.19、26.78±1.21 vs 11.13±0.87,P0.05)。A、B、C三組股骨頭成不同程度的骨髓腔內(nèi)脂肪細(xì)胞增生,骨小梁稀疏變細(xì),結(jié)構(gòu)紊亂、斷裂,空骨陷窩增多。D組股骨頭骨小梁致密,骨陷窩內(nèi)骨細(xì)胞形態(tài)正常,分布均勻,骨髓腔內(nèi)脂肪細(xì)胞形態(tài)正常,含量適中。結(jié)論：通過去勢(shì)及肌注激素建立了骨壞死與骨質(zhì)疏松的動(dòng)物模型,在早期兩個(gè)疾病具有相似的病理學(xué)改變,但也有不同之處,骨質(zhì)疏松的發(fā)生主要是由于影響了成骨細(xì)胞和破骨細(xì)胞的活性及二者的平衡；骨壞死的發(fā)生由脂肪細(xì)胞的增生、骨細(xì)胞脂肪變性起主導(dǎo)作用。為進(jìn)一步討論骨壞死與骨質(zhì)疏松的發(fā)病相關(guān)性及調(diào)控機(jī)制具有重要的理論和實(shí)踐意義。
[Abstract]:Objective: to establish a rabbit model of osteoporosis and osteonecrosis and compare the pathological changes of osteonecrosis and osteoporosis. Methods: 32 3-month-old female New Zealand white rabbits were randomly divided into 4 groups: group A (group A). There were 8 rats in group B (8 rats in castrated group, 8 rats in group C) (8 rats in castrated group and 8 rats in group D) (control group: sham operation group: 8 rats were injected with normal saline). In group C, the median incision was taken from the lower abdomen, and the bilateral ovary was removed completely. The other steps were the same as that in group C except for no ovarian ligation. Metronidazole was used to wash the abdominal cavity during the operation. All the animals were injected with penicillin 100,000 U / kg once a week after operation. After one week of operation, the animals in group A and C were injected with hydrocortisone 7.5 mg / kg twice a week. The animals in group D were injected with the same amount of normal saline gluteus muscle. Bone mineral density (BMD) was measured 5 weeks and 10 weeks after administration, and 4 animals were killed. The femoral heads were taken from both sides and stained with HE. Results BMD (unit mg / cm ~ 2) of lumbar vertebrae in group B and C was 246 鹵19 vs 269 鹵13 at 5 weeks after operation. 256 鹵22 vs 269 鹵13,236 鹵22 vs 273 鹵16) and D group at the same time (272 鹵19). Lumbar BMD at 10 weeks after operation was significantly higher than that before operation (221 鹵13 vs 269 鹵13,222 鹵18 vs 269 鹵13). 185 鹵11 vs 273 鹵16) and group D (263 鹵23) were significantly lower than those in group A (P 0.05). The BMD of proximal femur in group B and group C was significantly higher than that in group B and group C at 5W after operation compared with that before operation (256 鹵20 vs 306 鹵24,264 鹵20 vs 306 鹵21). The BMD(230 of proximal femur was decreased 10 weeks after operation (BMD(230 鹵22 vs 306 鹵24 in group D and in group D at the same time) (236 鹵46 vs 301 鹵22). 230 鹵17 vs 306 鹵21. 189 鹵39 vs 301 鹵22) and group D (297 鹵28) were significantly lower than those in group D (P 0.05). Only 10 weeks after operation in group C, BMD was lower than that in group D and before operation, and the mean value of BMD was less than 2.0 SDP 0.05g before operation and at the same time in group D, and 5 weeks after modeling. The positive rate of empty bone lacuna in group C was 15.20 鹵1.09 鹵14.13 鹵1.05 higher than that in group D. 18.53 鹵0. 67 vs10.40 鹵0. 97 vs10.40 鹵0. 97 P0. 05. The bone trabeculae of the three groups were sparse and partially fractured in varying degrees. 10 weeks after modeling, the bone trabeculae of the three groups were found to be sparse and partially ruptured. The positive rate of empty bone lacuna in group C was significantly higher than that in group D (22.43 鹵0.78 鹵21.20 鹵1.19 鹵26.78 鹵1.21 vs 11.13 鹵0.87). The femoral head in group P0.05, A, B, C had various degrees of proliferation of adipocytes, thinning of bone trabeculae, disordered structure, fracture and dense trabeculae of femoral head in group D. The morphology of bone cells in bone lacuna was normal, the distribution of bone cells was uniform, and the adipocytes in medullary cavity were normal and the content was moderate. Conclusion: the animal model of osteonecrosis and osteoporosis was established by castration and hormone injection. In the early stage, the two diseases have similar pathological changes, but there are also differences. The occurrence of osteoporosis is mainly due to the influence of osteoblast and osteoclast activity and the balance between them. Osteonecrosis is mainly caused by the proliferation of adipocytes and steatosis of osteocytes. It is of great theoretical and practical significance to further discuss the relationship between osteonecrosis and osteoporosis and its regulatory mechanism.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R361.2

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