摘要目的 研究高压氧(HBO)对激素性股骨头坏死(steroid-induced avasculal osteoecrosis of femoral head,SANFH)兔血中白介素19、20(interleukin-19、20,IL19、IL20)的影响.方法 健康新西兰白兔78只,随机分为3组:正常对照组(N组)7只,模型组(M组)41只,HBO组30只.M组又分为造模完成组(M0组)10只,造模2周组(M2组)10只,造模4周组(M4组)10只,造模6周组(M6组)11只.HBO组分为2周HBO组(HBO2组)7只,4周HBO组(HBO4组)11只,6周HBO组(HBO6组)12只.采用注射内毒素加甲基强的松龙的方法对模型组及HBO组动物进行造模处理,HBO 组在造模完成后开始HBO处理,1次/d,于造模2、4、6周分别取静脉血检测IL19、IL20的变化,并于取血后处死动物,取双侧股骨头进行组织形态学观察.结果 IL19表达:M0组明显增高,与N组比较差异有统计学意义(P＜0.05);M2、M4组表达较M0组下降,但M2组比HBO2组、M4组比HBO4组的表达高,差异有统计学意义(P＜0.01或P＜0.05).IL20表达:M0组明显增高,与N组比较差异有统计学意义(P＜0.05);M2组的表达较M0组下降,但比HBO2组表达高,差异具有统计学意义(P＜0.05);M4组与HBO4组比较差异无统计学意义(P＞0.05);M6组表达较M4高,HBO6组继续下降,与M6组比较差异有统计学意义(P＜0.05).病理结果:N组股骨头组织形态学正常;M2、M4组可见不同程度的骨髓腔内脂肪细胞变性及坏死,周围有淋巴细胞为主的炎性细胞浸润;M6组表现为骨髓腔纤维化,成骨表现活跃.HBO治疗2周后,股骨头骨细胞核未见明显固缩,骨小梁间骨髓炎症反应明显减轻,骨母细胞及纤维组织增生,治疗4～6周骨母细胞活跃增生,成骨形成.结论 SANFH时兔血中IL19、IL20含量增高,炎症反应是SANFH的病因之一.HBO治疗可抑制IL19、IL20的释放,减轻炎症反应,从而减轻股骨头坏死的程度.

abstractsObjective To investigate effects of HBO on serum IL19 and 1L20 in the animal model of steroid - induced avascular osteonecrosis of femoral head. Methods Seventy-eight healthy New Zealand male rabbits were randomly divided into 8 groups: group N ( the control group),group M2,M4,M6 ( the model groups) and the HBO therapy groups (HBO group 2,HBO group 4,HBO group 6). The animal model of steroid - induced avascular osteonecrosis of femoral head was developed by injections of endotoxin and methylprednisolone. Rabbits in the HBO group 2,HBO group 4,HBO group 6 received HBO therapy 1 hour a day,and the duration of HBO treatment were 2 weeks ( HBO group 2),4 weeks ( HBO group 4) and 6 weeks ( HBO group 6) respectively. Contents of IL19,IL20 in serum were measured and histological changes in the femoral heads were observed as well. Results IL19 in group M0 increased significantly,when it was compared with that of group N(P＜0.05);IL19 in group M2 and M4 were much higher than those in group HBO group 2,HBO group 4 (P ＜0.05,P ＜ 0.01 ). IL20 in group M0 also increased significantly,when compared with that of group N( P ＜0.05 );IL20 in group M2 and M4 were much higher than those in HBO group 2 and HBO group 4 as well( P ＜ 0.01 ). Histological examination of the tissues of the femoral head revealed osteonecrosis and inflammatory cells in M2 and M4 groups,and lighter osteonecrosis together with less inflammatory cells in HBO group 2 and HBO group 4 groups than in M2,M4 groups. Conclusions Contents of IL19,IL20 elevated in the rabbit model of steroid-induced avascular osteonecrosis of femoral head. HBO therapy could inhibit release of IL19 and IL20,alleviate inflammatory response and decrease the extent of osteonecrosis.