摘要
目的 探讨透明质酸钠关节内注射治疗兔实验性颞颌关节骨关节炎的效果 ,并与强的松龙进行比较。另对透明质酸钠的治疗机制进行初步探讨。方法 选择 12只日本大耳白兔 ,在双侧颞颌关节上腔各注射1.6 %木瓜蛋白酶溶液 0 .2 ml,3天后右侧再注射 0 .2 ml以诱发程度不同的骨关节炎。除 1只兔意外死亡外 ,11只兔均存活至预期时间。于末次注射后 1周 ,用 6只兔每周在双侧关节上腔各注射透明质酸钠 1.3mg作为实验组。另 5只兔双侧关节上腔各注射强的松龙 1.6 m g作为对照组。连续 4次。疗程结束后第 3、5及 7周分批处死动物 ,对关节进行病理学观察。结果 疗程结束后第 3、5及 7周 ,对照组双侧关节均可见明显结构破坏 ,以右侧较重 ;主要表现为纤维软骨变性 ,软骨变薄或脱落 ,关节面可见以不成熟的纤维细胞和成纤维细胞为主的不完全修复。实验组纤维软骨病变多表现为细胞轻度减少 ,纤维变性 ,甚至局部表层软骨缺损 ,周围软骨细胞簇状增生 ,数量增多 ,骨关节炎病理记分显著低于对照组。结论 透明质酸钠有修复和保护软骨的作用 ,强的松龙无助于软骨的修复 。
Objective To assess the treatment effect of sodium hyaluronate (HA) on experimental temporomandibular joint (TMJ) osteoarthritis of rabbits in comparison with prednisolone (PS). Methods The upper compartments of both TMJs of 12 Japanese White Ear Rabbits were injected with 0.2ml of 1.6% papain, 3 days after the right TMJs were injected again with same amount of papain to induce osteoarthritis with different severity levels. Except 1 rabbit was died accidently. After one week from final injection of papain, the upper compartments of both TMJs of 6 rabbits were injected with HA 1.3mg, 5 rabbits with PS 1.6mg weekly for 4 times. At 3, 5 and 7 weeks after the final injection, the rabbits were sacrificed and the TMJs were pathologically examined. Results The TMJs receiving PS showed predominant structural disorganization, and the right TMJs had much severe pathology. The manifestations were fibrillation, thinner or flaking of the articular cartilage of the temporal part of the joint, and the articular surface was covered with fibrous tissue. Whereas the TMJs receiving HA injections demonstrated limited changes of cartilage, less fibrillation, only local loss of cartilage on outside layer of the surface. In vicinity of the defect area, cluster of the chondrocytes appeared. Pathological scores of the TMJs receiving HA were significantly less than those of the TMJs reveiving PS. Conclusion The results suggest that hyaluronate have effect of cartilaginous reparation and protection for the osteoarthritis of rabbit. While prednisolone has no help or worsened for articular cartilage reparation.
出处
《中国修复重建外科杂志》
CAS
CSCD
2002年第1期5-10,共6页
Chinese Journal of Reparative and Reconstructive Surgery
