SH关节腔内注射治疗兔膝关节炎实验探究.docVIP

SH关节腔内注射治疗兔膝关节炎实验探究 　【关键词】 透明质酸钠 　　摘 要：［目的］探讨透明质酸钠（sodium hyaluronate，SH）关节腔内注射治疗膝骨性关节炎（OA）的效果。［方法］24只兔子建立骨关节炎动物模型，随机分OA组、SH组、对照组，观察3组软骨、滑膜细胞病理切片及软骨MMP1免疫组化，进行软骨Mankins评分，以及检测血液和关节液的IL1含量的效果。［结果］SH组可见软骨破坏减轻，滑膜纤维增生减少，Mankins评分有明显改善（P＜005）；血、膝关节滑液IL1浓度降低（P＜005），但关节软骨中MMP表达仍然活跃。［结论］SH能减少滑液中炎性介质IL1的分泌，从而减轻滑膜炎症，缓解对软骨细胞的破坏，延缓OA进展，但仍阻止不了OA进展。 关键词：透明质酸钠； 骨关节炎； 滑膜炎； 白介素1; 金属蛋白酶1 Abstract：［Objective］To observe the effects of intraartieular sodium hyaluronate injection on treatment of rabbit Osteoarthritis(OA)［Method］Twentyfour male rabbits were randomly divided into SH group,OA group and control group after established the model of OA,SH group，and control group were received intraarticular SH and physiologic injection one time a week at the same time respectivelyThe histological examinations of cartilage and synovia,immunohistochemistry of MMPl for cartilage,Mankin s scale were performedThe levels of IL1 of the serum and synovial fluid were determined by ELISE［Result］In the SH group showed the degeneration of the cartilage and fiber hyperplasia of synovia were light ened in the histological observation and the level of interleukin-1(IL1)of the serum and synovial fluid were also decrease（P＜005）The Mankin s scale of the control group was significantly decreased（P＜005）The expression of MMP1 of SH group was active［Conclusion］SH can relieve inflammation of synovia and reduce the secretion of IL1 in synovial fluid and serumSo it can lighten the degeneration of the cartilage and alleviate the pathology of OA,but it can not prevent the process of OA Key words：Sodium hyaluronate; Osteoarthritis; Synovitis; Interleukin 1; Matrix metalloproteinase1 骨关节炎（osteoarthritis，OA）是中老年的最常见关节疾患之一，是导致人群功能残疾、造成经济损失和影响社会发展的主要疾病之一〔1〕。随着我国的老年化的发展，OA的患病率将更加增高，它成为骨科研究的热点之一。 治疗OA的方法较多，其中关节腔注射透明质酸钠自1971年Peyron首次报道以来，至今国内外已在广泛应用，在临床上取得良好的效果〔2~3〕。动物实验也表明SH是治疗OA的一种有效药物，但SH治疗OA的机理仍不清楚，本研究从SH对兔OA病理过程细胞因子的作用及对软骨损害的评估来进一步探讨SH治疗OA的实际疗效，为临床的应用提供一定参考。 1 材料与方法 11 主要材料、试剂 111 实验动物 取雄性新西兰兔24只，体重25 kg左右，6个月龄，清洁