脂多糖对人工关节磨屑诱导的骨溶解的影响_医学论文.docVIP

脂多糖对人工关节磨屑诱导的骨溶解的影响_医学论文 脂多糖对人工关节磨屑诱导的骨溶解的影响_医学论文 作者：段钢 朱自强 陈宏亮 戈兵 【摘要】 目的 探讨脂多糖(LPS) 促进人工关节松动的可能性。方法 采集30例人体外周血,分离单核细胞(MOs)，分组培养。实验分4组（n=30）：A组(对照组)仅加入MOsB组加入MOs+LPS（100 μg/L），C组加入MOs+超高分子聚乙烯微粒(UHMWPE)D组加入MOs+UHMWPE+LPS（100 μg/L）。培养48 h后,放免法测定上清中肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的含量。结果 D组TNF-α和IL-6水平分别明显高于A、B、C组(P＜0.05)B组与C组之间TNF-α、IL-6水平差异无统计学意义(Pgt0. 05)。结论 LPS 能有效地刺激MOs分泌TNF-α、IL-6，效果与UHMWPE相似,且具有促进UHMWPE刺激TNF-α、IL-6分泌的作用，增强了UHMWPE的溶骨效应。 【关键词】 脂多糖人工关节；磨屑假体失败骨溶解 Abstract: Objective To explore the possibility of lipopolysaccharide (LPS) contributing to aseptic loosening of orthopedic implants. Methods 30 samples of peripheral blood were obtained from healthy human donors. Monocytes (MOs) were isolated and assigned to 4 groups （n=30 each） for culture. Group A was treated with MOs alone group B with MOs+LPS (100 μg/L) group C with MOs+ultrahigh molecular weight polylethylene (UHMWPE) debris group D with MOs+UHMWPE+LPS (100 μg/L). The cells were co-cultured for 48 h and the supernatant was tested for TNF-α and IL-6 content with radioimmunoassay. Results The levels of TNF-α and IL-6 were much higher in group D than in the other 3 groups. There was no significant difference in TNF-α and IL-6 levels between group B and group C (Pgt0.05). Conclusion LPS effectively stimulates MOs to secrete TNF-α and IL-6. LPS is not only similar to UHMWPE in action, but also promotes UHMWPE to stimulate the secretion of TNF-α and IL-6, therefore enhancing the osteolytic effect of UHMWPE. Key words: lipopolysaccharide artificial joint wear debris prosthesis failure osteolysis 人工关节的无菌性松动是影响关节置换术后远期疗效的主要因素［1］。在无菌性松动的假体周围可以看见骨质有明显的溶解现象，使其支撑结构破坏，致使假体松动［2］。近年来,越来越多的临床实践表明，脂多糖(LPS)可黏附多种人工假体材料并刺激细胞产生肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、白细胞介素6(IL-6)等溶骨性因子［3］，从而促进骨溶解。本实验通过人外周血单核细胞（MOs）、超高分子聚乙烯微粒(UHMWPE)和LPS的混合培养，探讨LPS对人工关节松动的促进作用，为揭示人工关节无菌性松动提供理论与实践依据。 　　1 资料和方法 　　1.1 主要试剂 　　LPS（E.coli.055:B5,Sigma公司）,RPMI 1640细胞培养液(GBCO公司) ,聚蔗糖-泛影葡胺分层液(FICOLL,上海试剂厂，沪Q/H G22222043289),小牛血清(特级,杭州四季青公司),六孔培养板(GBCO公司),TN