本刊首页 > 期刊目次 > 降脂抗凝联合应用与单纯降脂干预对兔激素性股骨头坏死影响对比研究

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降脂抗凝联合应用与单纯降脂干预对兔激素性股骨头坏死影响对比研究

  • 彭小明,李挺松,肖增明,詹新立

* 通信作者: 李挺松, 单位:广西医科大学第一附属医院脊柱外科 530021

摘要


目的:观察降脂联合抗凝应用与单纯降脂干预对兔激素性股骨头坏死(ONF)影响。

方法:52只健康成年雄性日本大白兔随机分为4组:生理盐水对照组(CTR组)、激素性股骨头坏死实验组(EXP组)、阿托伐他汀华法林治疗组(AW组)、单纯阿托伐他汀治疗组(AT组)。利用静脉注射大肠杆菌内毒素及肌肉注射甲基强的松龙,建立兔ONF动物模型。实验过程不同时点检测实验动物静脉血总胆固醇(Tch)、低密度脂蛋白与高密度脂蛋白比值(LDL:HDL)及血浆凝血酶原时间(PT)变化。实验终点处死动物观察股骨头大体病理及骨组织形态学改变判断ONF发生情况。

结果:从实验第4周开始到实验终点,与CTR组、AW组、AT组比较,EXP组Tch、LDL:HDL显著升高(P<0.05),AW组和AT组虽高于CTR组,但两组间无显著差别。实验第2周开始,AW组PT较CTR组、EXP组及AT组明显延长(P<0.05)。实验终点AW组、AT组实验动物ONF发生率分别为31%(4/13)、42%(5/12),两组间比较无显著差别(P>0.05),但分别显著低于EXP组67%(8/12)(P<0.05)。

结论:降脂联合抗凝应用可显著降低兔激素性ONF发生,但与单纯降脂干预比较无显著差异,提示可能主要从改善高脂状态获益。

关键词:股骨头坏死;糖皮质激素;兔;阿托伐他汀;华法林

ABSTRACT


Objective: To investigate the combined lipid lowering and anti-coagulant therapy versus simple lipid lowing intervention on the effects of corticosteroid-induced osteonecrosis of femoral head (ONF) in rabbit.

Methods: 52 healthy adult male Japanese white rabbits were randomly divided into four groups: normal saline group (CTR group), steroid-induced femoral head necrosis experimental group (EXP group), atorvastatin warfarin treated group (AW group) and atorvastatin alone treated group (AT group). Intravenous injection with endotoxin of E.coli and intramuscular injection with methylprednisolone were used to establish the ONF rabbit model. During the experimental process, the changes of venous total cholesterol (Tch), low-density lipoprotein and high density lipoprotein ratio (LDL: HDL) and prothrombin time (PT) of experimental animals were measured at different time point. At the end of the experiment, the rabbits were sacrificed, and determined the occurrence of ONF by observed the pathology of femoral head and the changes of bone histomorphology.

Results: From the fourth week to the end of the experiment, Tch and LDL: HDL were significantly increased in the EXP group, which compared to the CTR group, AW group and AT group (P<0.05). AW group and AT group although higher than the CTR group, but no significant difference between the two groups. The PT was significantly prolonged in AW group, which compared to CTR group, EXP group and AT group (P<0.05). At the end of the experiment, the occurrence rate of ONF in AW group and AT group were 31% (4/13) and 42% (5/12) individually, the two groups have no significantly difference, but were significantly lower than EXP group 67% (8/12) (P<0.05%).

Conclusion  : Lipid lowering and anticoagulant combination can reduce the occurrence of rabbit steroid-induced ONF, but with the simple lipid-lowering intervention showed no significant differences, suggest that may be mainly benefit from improved lipid status.

Key words: osteonecrosis of femoral head;glucocorticoid;rabbit;atorvastatin;warfarin

引用本文 / How to Cite This Article

彭小明,李挺松,肖增明,詹新立.降脂抗凝联合应用与单纯降脂干预对兔激素性股骨头坏死影响对比研究[J]. 国际精神病学杂志, 2016, 33(5): 766-769

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