摘要
目的探讨软骨解聚蛋白样金属蛋白酶-7(ADAMTS-7)基因上调与股骨头坏死发生之间的相关性。方法前瞻性选2017年4月至2018年5月121例股骨颈骨折患者,将70例股骨头坏死患者作为观察组,余单纯性股骨颈骨折无骨关节炎的患者作为对照组。取患者软骨标本,采用苏木精伊红染色和番红O染色观察患者软骨退化情况,Mankin评分观察软骨的降解情况,对比两组ADAMTS-7、肿瘤坏死因子-α(TNF-α)平均光密度表达、ADAMTS-7mRNA相对水平。结果苏木精伊红染色显示对照组患者细胞结构正常,只有较少软骨细胞坏死,软骨膜轻度异常,观察组患者软骨膜明显异常,软骨细胞坏死明显增多;番红O染色显示:对照组番红O染色正常,潮线完整,观察组染色明显退化,观察组Ⅳ期患者重度退化,潮线不完整。观察组Mankin评分明显高于对照组,观察组Ⅳ期Mankin评分也高于Ⅱ～Ⅲ期;观察组ADAMTS-7平均光密度、TNF-α平均光密度、ADAMTS-7 mRNA高于对照组,观察组Ⅳ期ADAMTS-7平均光密度、TNF-α平均光密度、ADAMTS-7 mRNA高于Ⅱ～Ⅲ期。结论软骨ADAMTS-7基因上调与股骨头坏死发生之间存在相关性,且ADAMTS-7参与了软骨退化的整个过程,在股骨头坏死的早期ADAMTS-7基因上调,股骨头坏死患者Ⅳ期时呈现高表达。
Objective To explore the correlation between the upregulation of cartilage ADAMTS-7 gene and the occurrence of femoral head necrosis. Methods From April 2017 to May 2018,121 patients with femoral neck fractures,70 patients with femoral head necrosis were selected as observation group,and patients with simple femoral neck fracture without osteoarthritis as control group. The cartilage specimens were taken. The cartilage degradation was observed by hematoxylin and eosin staining and Safranin O staining. The degradation of cartilage was observed by Mankin score. The expression of ADAMTS-7,TNF-α average optical density and ADAMTS-7 mRNA were compared. Results Eosin staining showed that the cell structure of the control group was normal,with less chondrocyte necrosis and mild abnormal cartilage. In the observation group,the perichondrium was abnormal,and the chondrocyte necrosis was significantly increased. The Safranin O staining showed that the control group had normal red staining and complete tidal line. The staining of the observation group was significantly degraded,and the patients in stage Ⅳ of the observation group were severely degenerated and the tidal line was incomplete. The Mankin score of the observation group was significantly higher than that of the control group. The Mankin score of the observation group was also higher than that of the Ⅱ to Ⅲ stage. The average optical density,average optical density of TNF-α and ADAMTS-7 mRNA of the ADAMTS-7 in the observation group were higher than those in the control group. The average optical density,TNF-α average optical density and ADAMTS-7 mRNA of group Ⅳ ADAMTS-7 were higher than those of stage Ⅱ~Ⅲ. Conclusion There is correlation between upregulation of cartilage ADAMTS-7 gene and occurrence of femoral head necrosis,Moreover,ADAMTS-7 is involved in the whole process of cartilage degeneration,and the ADAMTS-7 gene is up-regulated in the early stage of femoral head necrosis,and the femoral head necrosis is highly expressed in the Ⅳ stage.
作者
田红波
吴鸣
徐继平
TIAN Hong-bo;WU Ming;XU Ji-ping(Department of Orthopaedic,Shanghai Fengxian Central Hospital,Shanghai 201499,China)
出处
《临床和实验医学杂志》
2018年第23期2520-2523,共4页
Journal of Clinical and Experimental Medicine
基金
上海市卫生和计划生育委员会科研课题(编号:201540156)
