摘要
目的观察NEL样1型基因（NELL-1）直接体内转染治疗创伤性股骨头坏死的修复作用。方法雄性sD大鼠24只，采用抽签法分为假手术组、安慰剂组和NELL-1治疗组，每组8只。假手术组为正常对照组；NELL-1治疗组切开髋关节囊显露股骨头，将髋关节脱位，切断圆韧带，钝性分离股骨颈近端骨膜组织，建立股骨头坏死模型后1周，于术侧髋关节周注射NELL-1重组腺病毒载体；安慰剂组按NELL-1治疗组方法建模后相同时间注射等量等渗盐水。术后5周处死大鼠，取术侧股骨分别行股骨头形态改变大体观察，x线片测量股骨头高度与宽度比值（H／L），micro—CT测量股骨头总体积（TV）、骨组织体积（BV）、股骨头骨矿盐含量（TMC）、骨密度（BMD）、骨小梁厚度（Th．Th）和骨小梁间隙宽度（Tb．SP），组织学检查观察股骨头骨细胞、成骨细胞和破骨细胞活动情况。结果（1）大体观察：NELL-1治疗组见股骨头形态轻度变扁，安慰剂组则见股骨头明显变扁。各组均未观察到异位成骨现象。（2）X线片测量：NELL-1治疗组股骨头H／L（0．7532±0．0402）明显高于安慰剂组（0．5984±0．0370），低于假手术组（0．9202±0．0370）（P均〈0．01）。（3）micro—CT测量：三组间TV、BV、TMC、BMDNELL-1治疗组与假手术组差异无统计学意义（P〉0．05），但均大于安慰剂组（P〈0．05）；而Tb．Th、Tb．sP三组问差异均无统计学意义（P〉0．05）。（4）组织学检查：NELL-1治疗组股骨头内以活骨为主；与安慰剂组比较，存在活跃的成骨细胞活动而破骨细胞数也相应增加。结论NELL-1用于治疗大鼠创伤性股骨头坏死，可以促进成骨细胞活动、新生血管形成，保存骨量和股骨头形态，但同时提高了破骨细胞活动。
Objective To determine the effect of NEL-like type 1 gene （ NELL-1 ） transfection in vivo in the repair of traumatic femoral head necrosis. Methods Twenty-four SD rats were randomly divided into three groups （8 rats per group） according to the lottery method, ie, sham group （served as normal control）, NELL-1 treatment group （injected NELL-1 gene by recombinant adenovirus vectors around the hip one week after osteonecrosis model induced surgically） and placebo group （given an equal volume of saline solution at the same time after the induction of osteonecrosis）. Femurs were taken from the animals 5 weeks after surgery. Gross observation was performed for morphology changes, X-ray assessment for femoral head height and length ratio （ H/L）, Micro-CT measure for bone parameters of femoral head including total volume （ TV ）, bone volume （ BV ）, total mineralized content （ TMC ）, trabecular thickness （ Tb. Th） and trabecular space （ Tb. SP）, and histological study for osteocytes, osteoblasts and osteoclasts. Results Preserved femoral head shape was noted in NELL-1 treatment group compared to the obvious flattening of the femoral head in placebo group. No heterotopic osteogenesis was observed in any group. Femoral head H/L ratio for 0. 753 2 ± 0. 040 2 in NELL-1 treatment group was higher than 0. 598 4 ± 0.037 0 in placebo group （ P 〈 0.05 ）, but lower than 0. 920 2 ±0. 037 0 in sham group （P 〈 0.05 ）. TV, BV, TMC and BMD between NELL-1 treatment and sham groups did not differ significantly （ P 〉 0.05 ）, but all were increased compared to placebo group （ P 〈 0. 05 ）. There was no significant differences in Tb. Th and Tb. SP among three groups （ P 〉 0.05 ）. Most osteocytes were alive in NELL-1 treatment group. More active osteoblasts and osteoclasts were noted in NELL-1 treatment group than those in placebo group. Conclusion NELL-1 gene transfection can preserve femoral head shape and bone content, promote osteoblast activity and neovascularizat
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2016年第8期748-753,共6页
Chinese Journal of Trauma
基金
国家自然科学基金（30930092）
天津市卫生局科技基金（2012KY09）
关键词
骨坏死
股骨头
基因
转染
Osteonecrosis
Femoral head
Genes
Transfeetion
