摘要
目的：研究软骨下骨在骨性关节炎发病机制中的作用及其与关节软骨改变的相关性。方法于2012年11月-2013年11月时间收集膝关节骨性关节炎患者行全膝关节置换术时取出的胫骨平台样本30个，对标本进行Micro－CT断层扫描，获取胫骨平台样本的计算机三维图像和相关的骨小梁参数，图像空间分辨率为18μm ×18μm ×18μm。通过分析比较内外侧胫骨平台软骨下骨骨小梁结构参数的差异，为深入研究骨性关节炎的发病机制提供实验依据。结果晚期膝关节骨性关节炎患者软骨退行性变明显，软骨下骨骨小梁空间结构明显改变；骨小梁：内侧平台骨小梁体积分数（ BV／TV）、骨小梁厚度（ Tb．Th）和骨小梁数目（Tb．N）均显著高于外侧平台（P＜0．05），而骨小梁间距（Tb．Sp）显著低于外侧平台（P＜0．05）。结论内侧胫骨平台软骨退变较外侧明显，内侧平台软骨下骨骨小梁数目，骨小梁厚度及骨小梁体积分数增加，而骨小梁分离度是减小的。软骨下骨在骨性关节炎的发生和发展中起到了重要的作用。
Objective The study on role of subchondral bone in the pathogenesis of osteoarthritis（ OA） and its correlation with the change of articular cartilage.Methods From November 2012 to November 2013,30 specimens of tibial plateau were obtained from OA patients after total knee arthroplasty.Micro-CT scanning was done to obtain serial images of the specimens.Based on the two-dimen-sional images,special three-dimensional figures of the trabecular structure were reconstructed by computer with the voxel size being 18μm ×18μm ×18μm.By we comparing and analyzing the difference of subchondral bone between the medial and lateral plateau, the study will provide experimental basis for the pathogenesis of knee osteoarthritis.Results The three-dimensional parameters of the advanced patients with knee osteoarthritis cartilage and the subchondral bone trabecula collapsed regions were significantly different from those of the norma1 region.The medial plateau BV/TV,Tb.Th,Tb.N was significantly higher than that of lateral and the Tb.Sp was significantly lower than that of lateral（P〈0.05）.Conclusion Cartilage degeneration was more severe in the medial plateau than that of the lateral plateau. The BV/TV, Tb.Th and Tb.N of the medial plateau were significantly higher than those of the lateral plateau.The Tb.Sp of the medial plateau were significantly lower than those of the lateral plateau.The subchondral bone may play an important role in the initiation and progression of OA.
出处
《医学研究杂志》
2015年第7期121-124,共4页
Journal of Medical Research
