摘要
目的 探讨体外冲击波疗法(ESWT)对膝关节骨性关节炎(KOA)大鼠滑膜及软骨组织炎症因子的影响及机制。方法 30只雄性Sprague Dawley(SD)大鼠随机均分为对照组、模型组及冲击波组,对照组大鼠右侧关节腔注射50μL生理盐水,模型组与冲击波组大鼠右侧膝关节腔注射碘乙酸钠(MIA)2 mg/50μL构建KOA模型,均干预14 d;干预结束后对照组、模型组大鼠行冲击波声音刺激,冲击波组大鼠予ESWT治疗,1次/周、共4周;分别于术前和术后第3、7、14、21、28、35及42天,采用热刺痛仪和足底刺痛仪检测各组大鼠右后爪的热缩爪潜伏期(PWTL)和足底机械刺激缩足阈值(MWT);术后第42天,各组大鼠给予10%水合氯醛腹腔注射麻醉,行右膝关节X线检查,然后处死、取右侧膝关节,采用免疫组织化学法(IHC)检测各组大鼠膝关节滑膜和软骨组织白细胞介素-1β (IL-1β)、IL-6及肿瘤坏死因子-α(TNF-α)的表达水平。结果 模型组和冲击波组大鼠术后第3~42天的PWTL均较对照组缩短(P<0.05),冲击波组大鼠术后第28~42天的PWTL较模型组延长(P<0.05);模型组与冲击波组大鼠术后第3~42天的MWT均较对照组降低(P<0.05),冲击波组大鼠术后第21~42天MWT较模型组升高(P<0.05);与对照组比较,模型组与冲击波组大鼠关节间隙变窄,关节面粗糙变形程度较重,膝关节对线不齐,关节边缘有骨赘形成,且冲击波组上述X线表现轻于模型组;3组大鼠膝关节滑膜组织、软骨组织TNF-α、IL-1β及IL-6水平比较,对照组<冲击波组<模型组(P<0.05)。结论 ESWT可缓解KOA大鼠痛觉敏化症状及KOA疾病进展,其机制可能与减少滑膜和软骨组织中IL-1β、IL-6及TNF-α的表达有关。
Objective To investigate the effect and mechanism of extracorporeal shock wave therapy(ESWT)on inflammatory factors in synovial and cartilage tissues of the rats with knee osteoarthritis(KOA).Methods Thirty male Sprague Dawley(SD)rats were randomly divided into the control group,the model group and the shock wave group.The control group were injected with 50μL normal saline in the right joint cavity,and the model group and shock wave group were injected with 2 mg/50μL mono2-iodoacetate(MIA)in the right knee cavity to construct KOA models.After the intervention for 14 days,the control group and the model group received shock wave sound stimulation,and the shock wave group were treated with ESWT once a week for 4 weeks.The paw withdrawal thermal latency(PWTL)and the mechanical withdrawal threshold(MWT)of the right posterior paw were measured by Thermal stimulator and plantar sting apparatus 3,7,14,21,28,35,and 42 days before and after operation respectively.On the 42 nd day after operation,all rats were anesthetized by intraperitoneal injection of 10%chloral hydrate,X-ray examination of right knee joint was performed,and then killed and the right knee joint removed.The expressions of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in synovium and cartilage of knee joint were detected by immunohistochemical method(IHC).Results The PWTL of the model group and shock wave group was shorter than that of the control group on the 3 rd to 42 nd day after surgery(P<0.05),and PWTL of the shock wave group was longer on the 28 st and 42 nd day than that of the model group(P<0.05).The MWT of the model group and shock wave group was lower than that in the control group on the 3 rd to 42 nd day after surgery(P<0.05),and MWT of the shock wave group was higher than that in the model group on the 21 st and 42 nd day after surgery(P<0.05).Compared with the control group,the joint space of the model group and the shock wave group was more narrow,the joint surface was rough and deformed more severely,the alignment of the knee joint was uneven,and osteophytes were formed at the joint edge.The X-ray findings in the shock wave group were lighter than those in the model group.The levels of TNF-α,IL-1β,and IL-6 in synovial and cartilage tissues of knee joint of the 3 groups were as follow:the control group<shock wave group<model group(P<0.05).Conclusion ESWT can alleviate pain sensitization symptoms and the progression of KOA in rats,and the mechanism may be related to the decrease of IL-1β,IL-6,and TNF-αexpression in synovium and cartilage.
作者
杨兴月
黄圆月
安松松
毛冬梅
黄媛馨
杨俊龙
于子龙
秦乐
王林
沃春新
YANG Xingyue;HUANG Yuanyue;AN Songsong;MAO Dongmei;HUANG Yuanxin;YANG Junlong;YU Zilong;QIN Yue;WANG Lin;WO Chunxin(School of Anesthesiology,Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Pain,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)
出处
《贵州医科大学学报》
CAS
2024年第1期48-55,共8页
Journal of Guizhou Medical University
基金
贵州省卫健委科学技术基金项目(gzwjkj2020-1-137)
贵州医科大学国基培育项目(19nsp060)
贵州省卫健委科学技术基金项目(gzwkj2023-184)。
