复方丹参缓释系统植入治疗股骨头缺血性坏死实验探究.docVIP

复方丹参缓释系统植入治疗股骨头缺血性坏死实验探究 　 作者：黄相杰　姜红江　谭远超　刘德忠　周志高 【摘要】 　　［目的］探讨磷酸钙骨水泥（calcium phosphate cement，CPC）复方丹参缓释系统局部植入治疗股骨头缺血性坏死的机理。［方法］健康新西兰大白兔30只，制作股骨头坏死模型后，分为CPC组、CPC／丹参缓释系统组及对照组。于治疗后1、2、3和4周取标本，行HE染色和血管内皮细胞生长因子（vascular endothelial growth factor,VEGF）免疫组化染色，记录空骨陷窝率、VEGF阳性血管率、VEGF阳性成骨细胞率、VEGF阳性软骨细胞率。［结果］CPC／丹参缓释组空骨陷窝率较对照组及单纯CPC组明显降低，VEGF阳性血管率、VEGF阳性成骨细胞率、VEGF阳性软骨细胞率较其他2组明显增加（P＜0.01，P＜0.05）。［结论］CPC丹参缓释系统通过中药的局部缓释，可促进VEGF等细胞因子的分泌刺激血管内皮的增殖、分化，促进血管的生长和修复，从而改善、重建股骨头局部微循环，促进骨坏死修复。 【关键词】 股骨头坏死 磷酸钙骨水泥 丹参 局部应用 　　Experimental study on implantation of calcium phosphate cement/danshen drug delivery system for avascular necrosis of the femoral head∥ 　　Abstract：［Objective］To explore the role of implantation calcium phosphate cement（calcium phosphate cement）/Danshen drug delivery system for avascular necrosis of the femoral head.［Method］The New Zealand white rabbits were randomly divided into CPC/Danshen group,CPC group and the control groups after the model of avascular necrosis of the femoral head have been copied.The animals were killed at 1,2,3,4 weeks respectively after operation,histological examination and VEGF immunohistochemistry stain were done to determine the change in different groups.［Result］Compared to CPC group and the control group,the ratio of empty osteocytes lacuna dramatically decreased in CPC/Danshen group,and ratio of positive VEGF reaction of vessel,osteoblast,chondroblast significantly increased（P＜0.01,P＜0.05）.［Conclusion］With local application of traditional Chinese medicine,this improved procedure can promote the express of VEGF and local angiogenesis,which will benefit reconstruction of the local microcirculation and repair of the necrotic femoral head. 　　Key words：osteonecrosis of femoral head; calcium phosphate cement; danshen; drug delivery system 　　股骨头缺血性坏死是临床难治疾病，由于微循环障碍局部缺血，药物很难到达局部而发挥作用。因此采用药物局部缓释，保证局部药物高效、稳定、长期释放，对于治疗股骨头缺血性坏死尤为重要。本研究应用磷酸钙骨水泥（CPC）／丹参缓释系统植入治疗动物激素性股骨头缺血性坏死，观察中药的局部缓释对股骨头的微循环和骨性结构的影响，揭示CPC／丹参缓释系统治疗非创伤性股骨头缺血性坏死的机理。 　　1 材料与方法 　　1