经关节穿刺注射ADSCs修复兔激素性股骨头坏死的研究[摘要]目的探讨经关节穿刺注射脂肪源性干细胞（ADSCs）修复兔激素性股骨头缺血性坏死的疗效。方法取成年新西兰大白兔颈背部脂肪组织提取脂肪源性干细胞培养并传代，36只新西兰大白兔通过马血清联合激素法建立激素性股骨头缺血性坏死模型，随机分为对照组、髓芯减压组及ADSCs组，每组各12只，并作骨密度检测。对照组不作干预处理，髓芯减压组股骨头钻孔减压，ADSCs组经关节穿刺注射ADSCs。分别于干预后4、8周每组取6只兔行骨密度检测及X线检查，处死后收集股骨头样本作大体观察，采用HE染色及PCR检测BMP-2mRNA的表达，通过各组比较探讨经关节穿刺注射ADSCs修复激素性股骨头缺血性坏死的效果。结果干预后4、8周，三组骨密度呈下降趋势，但对照组下降幅度更大，与髓芯减压组、ADSCs组比较差异有统计学意义（P<0.05），而髓芯减压组与ADSCs组相比较差异无统计学意义（P>0.05）；大体观察、影像学及组织学表现，干预后4、8周与对照组比较，经关节穿刺注射ADSCs及髓芯减压均可延缓股骨头坏死的进展，对股骨头坏死起修复作用，ADSCs组优于髓芯减压组；干预后4、8周，ADSCs组及髓芯减压组BMP-2mRNA的表达水平均高于对照组，差异有统计学意义（P<0.05），而髓芯减压组与ADSCs比较差异无统计学意义（P>0.05）。结论经关节穿刺注射ADSCs对兔激素性股骨头缺血性坏死有修?妥饔谩?[关键词]激素性股骨头缺血性坏死；脂肪源性干细胞；关节穿刺；修复[]R6874[文献标识码]A[]1673-7210（2018）03（a）-0175-06Repairofrabbitsteroid-inducedavascularnecrosisoffemoralheadbyADSCsinjectionthroughthejointpunctureTANWeiyuanANRongzeQIXinwenXIE激aqingDepartmentofOrthopedics，theFifthAffiliatedHospitalofZunyiMedicalCollege，GuangdongProvince，Zhuhai519100，China[Abstract]ObjectiveToinvestigatetheeffectofadiposederivedstemcells（ADSCs）injectionthroughthejointpunctureontherepairofsteroid-inducedavascularnecrosisoffemoralheadinrabbits.MethodsADSCswereisolatedandpassagedfromtheneckadiposetissueofadultNewZealandwhiterabbits.Thirty-sixNewZealandwhiterabbitswereusedtoestablishthemodelofsteroid-inducedavascularnecrosisoffemoralheadbyhorseserumcombinedwithhormone.Theserabbitswererandomlydividedintocontrolgroup，coredecompressiongroupandADSCsgroup（12rabbitsineachgroup），andallforbonedensitydetection.Controlgroup：nointervention；coredecompressiongroup：femoralheaddrillingdecompression；ADSCsgroup：byintra-articularinjectionofADSCs.At4weeksand8weeksafterintervention，6rabbitsineachgroupwereexaminedwithbonemineraldensity（BMD）andX-rayexamination.Afterthedeath，theirfemursampleswerecollectedforgrossobservation，HEstainingandPCRwereusedforthemeasurementofBMP-2mRNA.ThroughthecomparisonofeachgrouptoexploretheeffectofADSCsrepairingsteroid-inducedavascularnecrosisofthefemoralheadbyjointpunctureinjection.Results4weeksand8weeksafterinterventionthreegroupsofBMD，butthecontrolgroupdecreased，comparedwithcoredecompressiongroupandADSCsgroupwerestatisticallysignificant（P<0.05），buttherewasnosignificantdifferencebetweenthecoredecompressiongroupandtheADSCsgroup（P>0.05）.Generalobservation，imagingandhistologicalfindingsat4weeksand8weeksafterintervention，comparedwiththecontrolgroup，ADSCstreatmentbyjointpunctureinjectionandcoredecompressionbothcandelaytheprogressoffemoralheadnecrosis.Therehadarepaireffectonfemoralheadnecrosis，andtheeffectsinADSCsgroupwerebetterthanthoseincoredecompressiongroup；at4weeksand8weeksafterintervention，theexpressionofBMP-2mRNAintheADSCsgroupandthecoredecompressiongroupwerebothhigherthanthoseinthecontrolgroup，thedifferenceswerestatisticallysignificant（P<...