联合用药预防激素性股骨头坏死对血浆一氧化氮含量的影响(1)
【摘要】 目的 观察联合用药预防激素性股骨头坏死对血浆NO含量的影响，探讨联合用药预防的作用机制。方法 30只兔随机分成三组：对照组同期肌内注射生理盐水；激素组是给予糖皮质激素肌注；治疗组在给予同剂量糖皮质激素同时，每日使用血塞通、脂必妥和阿仑膦酸钠；观察股骨头组织学变化，用免疫组化技术检测血浆NO含量的变化。结果 激素组股骨头软骨下骨小梁稀疏、断裂，脂肪细胞直径增大，空骨陷窝较多，血浆NO含量显著低于对照组；治疗组股骨头软骨下骨小梁结构较正常，血浆NO含量显著高于激素组。结论 联合应用血塞通、脂必妥和阿仑膦酸钠能预防和减缓激素性股骨头的发生，血浆NO含量升高是联合用药预防的作用途径之一。
【关键词】糖皮质激素；股骨头坏死；一氧化氮
Effect of drugs preventing steroid-induced osteonecrosis of the femoral head on the content of nitric oxide in plasma
, http://www.100md.com
CHEN Xiu-qin,LI Jing-tian,ZOU Jin-hui,et al.Department of Physiology,Medical College of Shaoguan University,Guangdong 512026,China
【Abstract】 Objective To observe the effect of drugs preventing steroid-induced osteonecrosis of the femoral head on the content of nitric oxide in plasma in order to investigate the role of the joint drug in the prevention mechanism.Methods Thirty rabbits were divided randomly into 3 groups:group A,guoup B and group C.Rabbits in group A were injected with normal saline; rabbits in group B were treated with glucocorticoid; rabbits in group C were treated with glucocorticoid as that in group B,and meanwhile,orally received the panax notoginseng saponins,zhibituo and alenduonate for 8 weeks.Histopathological structure and the content of nitric oxide in plasma were observed.Results The trabecula of femoral head of the B group changedthinner and more sparse,the bone marrow cavity with edema and large fatty cells were also observed and the content of nitric oxide in plasma of group B was significantly lower than those of group A.The trabecula of femoral head of the C group was normal and the content of nitric oxide in plasma of group C was significantly higher than those of group B.Conclusion The Zhibituo,Panax notoginseng saponins and Alenduonate may prevent steroid-induced necrosis of femoral head and the rising of the content of nitric oxide in plasma was one of the way of drugs preventing steroid-induced osteonecrosis of the femoral head.
, 百拇医药
【Key words】Glucocorticoid; Necrosis of femoral; Nitric oxide
激素性股骨头坏死的发病率占非创伤性股骨头坏死首位，并有增高趋势，已引起广泛的重视。但目前关于激素性股骨头缺血性坏死的研究多集中在治疗已形成的坏死，对在使用激素过程中如何预防股骨头坏死，研究较少[1]。本课题组在建立激素性股骨头坏死动物模型的过程中，采用血塞通、脂必妥和阿仑膦酸钠联合用药进行预防性治疗，结果证实联合用药预防可提高股骨头血流量，改善骨组织结构和血液流变学指标，预防或减缓激素性股骨头坏死[2，3]。本实验是进一步观察联合用药对血浆一氧化氮(nitric oxide，NO)含量的影响，探讨联合用药预防激素性股骨头坏死的作用机制。
1 材料和方法
1.1 实验动物 成年新西兰大白兔30只，不分雌雄，体质量(2.5±0.5)kg，普通级，所有动物在同等条件下饲养，自由摄水和摄食，动物和饲料均由广东省实验动物中心提供。
, 百拇医药
1.2 药品 血塞通片(主要成分为三七总皂甙，玉溪市维和制药有限公司，生产批号200410290，25 mg/片)；脂必妥片(主要成分为山楂、白术、红曲，成都地奥九泓制药厂，产品批号0410063，350 mg/片)；阿仑膦酸钠片(主要成分为4-氨基-1-羟基亚丁基-1，海南曼克星制药厂生产，批号 040501，5 mg/片)；(河南天康制药有限公司生产，生产批号 040905，5 g /L)。
1.3 实验方案 动物先适应实验环境1周后，随机分为对照组、激素组、治疗组，每组10只。对照组每周肌注1 ml生理盐水2次(星期一和星期四，下同)；激素组每周2次肌注地塞米松磷酸钠注射液1 ml；治疗组每周2次肌注地塞米松磷酸钠注射液1 ml，从注射地塞米松第1天开始每天灌喂血塞通25 mg、脂必妥350 mg和阿仑膦酸钠5 mg。三组动物均每周2次肌注青霉素5万U/只，预防感染，连续用药8周。停药1周后三组动物同时进行有关指标检测。
1.4 NO的测定 通过测定血浆的NO-3浓度间接反映NO的含量，试剂盒购自南京建成生物工程研究所，采用硝酸盐还原酶还原法，应用722光栅分光光度计进行自动比色读数。
1.5 形态学观察 将动物股骨头沿冠状面中间劈开，将一半股骨头用10%福尔马林固定、5%硝酸溶液脱钙后，石腊包埋，苏木精-伊红染色，光镜下观察形态学变化，任取10个高倍视野内的骨陷窝，计数空骨陷窝，求空骨陷窝率。, 百拇医药(陈秀琴 李景田 邹锦慧 张慧明 黄 伟 李佰灵 周小璜)
【关键词】糖皮质激素；股骨头坏死；一氧化氮
Effect of drugs preventing steroid-induced osteonecrosis of the femoral head on the content of nitric oxide in plasma
, http://www.100md.com
CHEN Xiu-qin,LI Jing-tian,ZOU Jin-hui,et al.Department of Physiology,Medical College of Shaoguan University,Guangdong 512026,China
【Abstract】 Objective To observe the effect of drugs preventing steroid-induced osteonecrosis of the femoral head on the content of nitric oxide in plasma in order to investigate the role of the joint drug in the prevention mechanism.Methods Thirty rabbits were divided randomly into 3 groups:group A,guoup B and group C.Rabbits in group A were injected with normal saline; rabbits in group B were treated with glucocorticoid; rabbits in group C were treated with glucocorticoid as that in group B,and meanwhile,orally received the panax notoginseng saponins,zhibituo and alenduonate for 8 weeks.Histopathological structure and the content of nitric oxide in plasma were observed.Results The trabecula of femoral head of the B group changedthinner and more sparse,the bone marrow cavity with edema and large fatty cells were also observed and the content of nitric oxide in plasma of group B was significantly lower than those of group A.The trabecula of femoral head of the C group was normal and the content of nitric oxide in plasma of group C was significantly higher than those of group B.Conclusion The Zhibituo,Panax notoginseng saponins and Alenduonate may prevent steroid-induced necrosis of femoral head and the rising of the content of nitric oxide in plasma was one of the way of drugs preventing steroid-induced osteonecrosis of the femoral head.
, 百拇医药
【Key words】Glucocorticoid; Necrosis of femoral; Nitric oxide
激素性股骨头坏死的发病率占非创伤性股骨头坏死首位，并有增高趋势，已引起广泛的重视。但目前关于激素性股骨头缺血性坏死的研究多集中在治疗已形成的坏死，对在使用激素过程中如何预防股骨头坏死，研究较少[1]。本课题组在建立激素性股骨头坏死动物模型的过程中，采用血塞通、脂必妥和阿仑膦酸钠联合用药进行预防性治疗，结果证实联合用药预防可提高股骨头血流量，改善骨组织结构和血液流变学指标，预防或减缓激素性股骨头坏死[2，3]。本实验是进一步观察联合用药对血浆一氧化氮(nitric oxide，NO)含量的影响，探讨联合用药预防激素性股骨头坏死的作用机制。
1 材料和方法
1.1 实验动物 成年新西兰大白兔30只，不分雌雄，体质量(2.5±0.5)kg，普通级，所有动物在同等条件下饲养，自由摄水和摄食，动物和饲料均由广东省实验动物中心提供。
, 百拇医药
1.2 药品 血塞通片(主要成分为三七总皂甙，玉溪市维和制药有限公司，生产批号200410290，25 mg/片)；脂必妥片(主要成分为山楂、白术、红曲，成都地奥九泓制药厂，产品批号0410063，350 mg/片)；阿仑膦酸钠片(主要成分为4-氨基-1-羟基亚丁基-1，海南曼克星制药厂生产，批号 040501，5 mg/片)；(河南天康制药有限公司生产，生产批号 040905，5 g /L)。
1.3 实验方案 动物先适应实验环境1周后，随机分为对照组、激素组、治疗组，每组10只。对照组每周肌注1 ml生理盐水2次(星期一和星期四，下同)；激素组每周2次肌注地塞米松磷酸钠注射液1 ml；治疗组每周2次肌注地塞米松磷酸钠注射液1 ml，从注射地塞米松第1天开始每天灌喂血塞通25 mg、脂必妥350 mg和阿仑膦酸钠5 mg。三组动物均每周2次肌注青霉素5万U/只，预防感染，连续用药8周。停药1周后三组动物同时进行有关指标检测。
1.4 NO的测定 通过测定血浆的NO-3浓度间接反映NO的含量，试剂盒购自南京建成生物工程研究所，采用硝酸盐还原酶还原法，应用722光栅分光光度计进行自动比色读数。
1.5 形态学观察 将动物股骨头沿冠状面中间劈开，将一半股骨头用10%福尔马林固定、5%硝酸溶液脱钙后，石腊包埋，苏木精-伊红染色，光镜下观察形态学变化，任取10个高倍视野内的骨陷窝，计数空骨陷窝，求空骨陷窝率。, 百拇医药(陈秀琴 李景田 邹锦慧 张慧明 黄 伟 李佰灵 周小璜)