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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
【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
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.?
【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
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