本文選題：骨性關(guān)節(jié)炎　切入點(diǎn)：臭氧　出處：《山西醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 1.CT導(dǎo)引下成功建立兔膝骨性關(guān)節(jié)炎動(dòng)物模型,選擇關(guān)節(jié)軟骨最佳MR成像序列,并做分組對(duì)照觀察 2.探討CT導(dǎo)引下O3干預(yù)治療兔膝骨性關(guān)節(jié)炎,觀察實(shí)驗(yàn)兔關(guān)節(jié)軟骨部分炎性介質(zhì)IL-1、TNI-a、MMP-13的表達(dá)情況 3.本課題將兔膝關(guān)節(jié)炎關(guān)節(jié)軟骨MR上微細(xì)變化與免疫組化表達(dá)相對(duì)照,來(lái)進(jìn)一步探討臭氧對(duì)軟骨細(xì)胞的影響及其機(jī)制 方法： 1、建立動(dòng)物模型 將4%木瓜蛋白酶0.3m1通過(guò)關(guān)節(jié)腔內(nèi)注射法注入兔膝關(guān)節(jié)的雙后肢,制成兔膝骨性關(guān)節(jié)炎模型。 2.動(dòng)物分組 隨機(jī)抽取6只實(shí)驗(yàn)兔作為對(duì)照組,通過(guò)MR雙側(cè)兔膝關(guān)節(jié)檢查,將剩余成功造模后的實(shí)驗(yàn)動(dòng)物隨機(jī)分為：骨性關(guān)節(jié)炎組,醫(yī)用臭氧組,玻璃酸鈉組。正常對(duì)照組及骨性關(guān)節(jié)炎組不做任何處理,玻璃酸鈉組向雙側(cè)膝關(guān)節(jié)腔內(nèi)每次每側(cè)注射1%濃度的SH1ml,注射頻率為1次/周,連續(xù)4周注射；醫(yī)用臭氧組向雙膝關(guān)節(jié)內(nèi)每次第側(cè)注入濃度為35ug/ml臭氧5ml；注射頻率為1次/周,連續(xù)4周注射,治療1周后再次對(duì)雙側(cè)膝關(guān)節(jié)行MR檢查,完成后一并處死所有實(shí)驗(yàn)動(dòng)物。 3..軟骨組織中IL-1、TNF-a及MMP-13的檢測(cè) 切取實(shí)驗(yàn)兔雙側(cè)股骨內(nèi)側(cè)髁關(guān)節(jié)軟骨并修剪成1×1×2mm3小長(zhǎng)條,采用DAB法檢測(cè)關(guān)節(jié)軟骨細(xì)胞IL-1、TNF-a及MMP-13的陽(yáng)性表達(dá)。 結(jié)果： 1.CT引導(dǎo)下兔膝骨性關(guān)節(jié)炎動(dòng)物模型成功建立。 2.臭氧干預(yù)治療兔膝骨性關(guān)節(jié)炎前后,軟骨組織中IL-1、TNF-a及MMP-13的表達(dá)存在變化且其變化趨勢(shì)較一致。 3.IL-1、TNF-a及MMP-13陽(yáng)性表達(dá)率：OA、03、SH三組均高于正常對(duì)照組(P0.05),03組與SH組低于OA組(P0.05)。03組與SH組無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。 4.MR檢查及免疫組化結(jié)果顯示,實(shí)驗(yàn)組兔膝關(guān)節(jié)腔內(nèi)注射臭氧或玻璃酸鈉,均對(duì)關(guān)節(jié)炎病變有一定抑制作用,兩種治療方法的療效差異無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.臭氧干預(yù)治療兔膝骨性關(guān)節(jié)炎,能引起軟骨組織中IL-1、TNF-a及MMP-13這三種炎性介質(zhì)表達(dá)程度的改變,且其變化趨勢(shì)與免疫組化結(jié)果表達(dá)情況較一致。 2.醫(yī)用臭氧經(jīng)膝關(guān)節(jié)腔內(nèi)注射對(duì)骨關(guān)節(jié)炎動(dòng)物模型的關(guān)節(jié)軟骨有修復(fù)作用,使關(guān)節(jié)軟骨中IL-1、TNF-a、MMP-13表達(dá)減少,軟骨表面較光整、裂隙生成減少、細(xì)胞增生等退變延緩現(xiàn)象,MR上顯示各組實(shí)驗(yàn)兔關(guān)節(jié)軟骨上存在著信號(hào)變化,由此可見(jiàn)IL-1、TNF-a、MMP-13的表達(dá)減少與病理及MR上變化的軟骨退變好轉(zhuǎn)對(duì)應(yīng),證明臭氧具有治療骨關(guān)節(jié)炎的潛在可能性。
[Abstract]:Objective:. 1. The animal model of rabbit knee osteoarthritis was successfully established under the guidance of CT, and the optimal Mr imaging sequence of articular cartilage was selected and compared with each other. 2. To investigate the treatment of knee osteoarthritis with O3 under the guidance of CT, and observe the expression of TNI-a MMP-13, a partial inflammatory mediator of articular cartilage, in rabbits. 3. In order to further explore the effect of ozone on chondrocytes and its mechanism, we compared the fine changes of articular cartilage on Mr and the expression of immunohistochemistry in rabbit knee arthritis. Methods:. 1. Establish animal model. The rabbit knee osteoarthritis model was established by injecting 4% papain 0.3 M1 into the hind limbs of the knee joint. 2. Animal subgroup. Six experimental rabbits were randomly selected as control group. The remaining rabbits were randomly divided into osteoarthritis group and medical ozone group. Sodium hyaluronate group. The normal control group and osteoarthritis group did not do any treatment. Sodium hyaluronate group injected 1% concentration of SH1 ml into each side of bilateral knee joint each time, the injection frequency was once a week for 4 weeks. In the medical ozone group, the concentration of ozone at the first side of each knee joint was 35ug-ml / ml, and the injection frequency was once a week for 4 weeks. After one week of treatment, the bilateral knee joints were again examined by Mr, and all the experimental animals were killed after the completion of the injection. 3. Detection of IL-1TNF- 偽 and MMP-13 in chondrocytes. The articular cartilage of bilateral medial femoral condyle was cut and pruned into 1 脳 1 脳 2 mm3 strips. The expression of IL-1TNF-a and MMP-13 in articular chondrocytes was detected by DAB method. Results:. 1. The animal model of knee osteoarthritis was successfully established under CT guidance. 2. The expression of IL-1TNF-a and MMP-13 in cartilage tissue of rabbits with knee osteoarthritis treated by ozone intervention was changed and the change trend was consistent. 3. The positive expression rates of TNF-a and MMP-13 in the three groups were higher than those in the normal control group (P 0.05) and SH group (P 0.05). There was no significant difference between the three groups (P 0.05) and SH group (P 0.05). 4. The results of Mr and immunohistochemistry showed that the injection of ozone or sodium hyaluronate into the knee joint of the experimental group had a certain inhibitory effect on the pathological changes of arthritis, and there was no significant difference between the two treatment methods. Conclusion:. 1. Ozone intervention in the treatment of knee osteoarthritis caused changes in the expression of IL-1TNF- a and MMP-13 in cartilage tissue, and the change trend was consistent with the expression of immunohistochemical results. 2.Intra-articular injection of medical ozone can repair the articular cartilage of the animal model of osteoarthritis, which can reduce the expression of IL-1TNF- 偽 MMP-13, smooth the cartilage surface and decrease the formation of cracks in the articular cartilage. The signal changes on the articular cartilage of the experimental rabbits showed that the decrease of the expression of MMP-13 in TNF-a was correlated with the pathological changes and the change of cartilage degeneration on Mr. Ozone is a potential therapy for osteoarthritis.
【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】：2013
【分類號(hào)】：R684.3;R816.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 林木南;劉獻(xiàn)祥;;骨性關(guān)節(jié)炎中細(xì)胞因子的協(xié)同效應(yīng)[J];福建中醫(yī)學(xué)院學(xué)報(bào);2006年02期

2 陳巍;李彬;唐中堯;徐祖健;楊洪彬;;膝骨性關(guān)節(jié)炎患者關(guān)節(jié)滑液IL-1β和TNF-α的表達(dá)及臨床意義[J];廣東醫(yī)學(xué);2010年15期

3 甄俊平,王峻;關(guān)節(jié)軟骨的MRI研究及應(yīng)用[J];山西臨床醫(yī)藥;2001年05期

4 蔣太軍;;骨性關(guān)節(jié)炎膝關(guān)節(jié)液丙二醛和腫瘤壞死因子-α的檢測(cè)及意義[J];現(xiàn)代醫(yī)藥衛(wèi)生;2009年06期

5 任保入;孫清慧;郭峰;修志紅;張靜;;膝關(guān)節(jié)腔注射玻璃酸鈉聯(lián)合痛點(diǎn)水針刀治療骨關(guān)節(jié)炎[J];當(dāng)代醫(yī)學(xué)(學(xué)術(shù)版);2007年06期

6 管劍龍;;骨關(guān)節(jié)炎的實(shí)驗(yàn)室和影像學(xué)診斷[J];診斷學(xué)理論與實(shí)踐;2006年04期

7 黃武君;談志龍;白人驍;;細(xì)胞因子與骨性關(guān)節(jié)炎軟骨退變的研究現(xiàn)狀[J];中國(guó)骨傷;2006年10期

8 周尊謙,謝林,孫達(dá)武;丹紫康膝沖劑治療膝關(guān)節(jié)退行性骨關(guān)節(jié)病臨床研究[J];中國(guó)骨傷;1999年02期

9 婁思權(quán);骨關(guān)節(jié)炎的病理與發(fā)病因素[J];中華骨科雜志;1996年01期

10 馬錦玲;孟慶義;;不明原因發(fā)熱的診斷進(jìn)展[J];中華老年多器官疾病雜志;2005年04期

，

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