摘要
目的研究体外冲击波治疗(ESWT)对兔膝骨关节炎关节软骨保护和软骨下骨重塑的作用和机制。方法健康成年5月龄新西兰兔24只,随机分为膝关节前交叉韧带切断术(ACLT)组和ESWT+ACLT组,每组12只。两组行左侧ACLT造膝骨关节炎模型。术后2个月ESWT+ACLT组实施体外冲击波干预治疗:在左膝关节股骨内外侧髁和胫骨平台内外侧,以能量为0.16MPa/次、1 200次/侧进行干预。每周干预3次,间隔一周再干预,干预4周共6次。ACLT组术后未行任何干预。干预完成后,两组取左侧膝股骨远端和胫骨近端作宏观形态计量学评价;每组取6只动物行关节软骨微观形态计量学评价、软骨下骨骨矿物质密度(BMD)测定以及微观形态计量学分析;其余6只行软骨中基质金属蛋白酶(MMP)-1、MMP-3、MMP-13和基质金属蛋白酶抑制因子-1(TIMP-1)基因表达分析;取关节滑液作白介素(IL)-1β、肿瘤坏死因子(TNF)-α和一氧化氮(NO)含量分析。结果 ACLT+ESWT组较ACLT组,股骨内侧髁软骨宏观和微观形态计量学评分降低(P<0.05),其他部位与ACLT组相比差异无统计学意义(P>0.05);股骨远端BMD升高(P<0.05);股骨和胫骨软骨下骨骨小梁面积、骨小梁厚度和骨小梁间隙降低(P<0.05),骨小梁数目差异无统计学意义(P>0.05);关节软骨中MMP-1、MMP-3和TIMP-1基因表达降低(P<0.05);关节滑液中IL-1β、TNF-α和NO含量差异无统计学意义(P>0.05)。结论 ESWT(能量0.16MPa/次、1 200次/侧、每周干预3次、共计6次/4周)可对兔膝骨关节炎的软骨损伤和软骨下骨硬化起到保护作用。
Objective To investigate the role of extracorporeal shock wave therapy on the protection of cartilage and subcbondral bone remodeling in rabbits with osteoarthritis induced by anterior cruciate ligament transaction （ACLT）. Methods Anterior cruciate ligament transaction was performed on 24 adult rabbits to establish knee osteoarthritis models. The rabbits were randomly divided into two groups, with one group receiving extracorporeal shock wave therapy （ESWT） and the other group serving as controls. The ESWT was set at energy 0. 16 MPa/time, frequency 5 Hz, 1 200 shock per side, 3 times per week, and a total of 6 times in 4 weeks. Histological observations were undertaken with articular cartilages under mascroscope and microscope; bone mineral density （BMD） was measured. The subchondral bones of femoralcondyle and tibial plateau were given a bone histomorphometry analysis. The levels of interleukin-1 beta （IL-1β）, tumor necrosis factor alpha （TNF-α） and nitric oxide （NO） were detected by ELISA. The expressions of matrix metalloproteinases （MMP-1, MMP-3, MMP-13） and tissue inhibitor of metalloproteinases 1 （TIMP-1） in cartilage were determined by RT-PCR. Results Lower levels of histological result in medial femoral condyles （by both mascroscope and microscope examinations） and higher levels of BMD （in distal femora） were found in the ESWT treated rabbits compared with the controls （P〈0.05）. The ESWT treated rabbits also had decreased trabecular bone relative volume and trabecular bone thickness, increased bone separation, lower levels of expressions of MMP-1 and MMP-3, and higher levels of TIMP 1. Conclusion ESWT can protect cartilage from damages and prevent subchondral sclerosis through regulating MMP-1, MMP-3 and TIMP-1 in cartilages and modulating subchondral bone metabolisms.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2014年第1期120-125,共6页
Journal of Sichuan University(Medical Sciences)
基金
国家自然科学基金(No.30672215和No.81171865)资助
关键词
骨关节炎
软骨
软骨下骨
体外冲击波
Osteoarthritis Cartilage Subchondral bone Extracorporeal shock wave
