抗凝联合他汀类降脂药治疗激素性股骨头坏死大鼠模型疗效及机制研究-东南大学学报医学版

抗凝联合他汀类降脂药治疗激素性股骨头坏死大鼠模型疗效及机制研究

单位：河北医科大学第一医院骨科, 河北石家庄 050031

分类号：R683.42

出版年·卷·期（页码）：2019·38·第一期（131-135）

摘要：

目的：探究抗凝联合他汀类降脂药治疗激素性股骨头坏死大鼠模型疗效及机制。方法：大鼠分为对照组、模型组和观察组，使用大肠杆菌内毒素和甲基强地松龙复制激素性股骨头坏死大鼠模型，模型复制后观察组大鼠灌胃华法林和阿托伐他汀。比较各组大鼠形态、股骨头X线观察结果、股骨头骨密度、血清中磷、钙和血管内皮生长因子（VEGF）水平、血浆中总胆固醇（Tch）测试盒和低密度脂蛋白（LDL）水平。结果：与模型组比较，观察组大鼠模型复制后的精神状态、毛发色泽、活动量均显著的改善，观察组大鼠模型复制后股骨头的大体形态得到有效的改善，骨密度均一，股骨头光滑，骨小梁清晰；模型复制后，观察组大鼠股骨头骨密度、血清中的磷和钙水平显著高于模型组（P<0.05），观察组大鼠血清中的磷和钙水平、VEGF均显著高于模型组（P<0.05），观察组大鼠血浆PT和t-PA水平、血清TCH和LDL水平均显著低于模型组（P<0.05）。结论：抗凝联合降脂治疗激素性股骨头坏死时可以收到显著的疗效。其作用机制可能为通过降脂和抗凝，改善股骨头坏死部位的血液循环，促进血管再生，促进骨细胞生长。

Objective:To explore the efficacy and mechanism of anticoagulant combined with statins in the treatment of steroid induced osteonecrosis of the femoral head in rats. Methods:Rats were divided into three groups:control group, model group and observation group. The steroid-induced femoral head necrosis model was induced by Escherichia coli endotoxin and methylprednisolone. After the model was duplicated, warfarin and Atto vastatin were administered intragastrically in the observation group. The morphology, femoral head X-ray findings, bone mineral density, serum phosphorus, calcium and vascular endothelial growth factor (VEGF) levels, plasma total cholesterol (Tch) test box and low density lipoprotein (LDL) levels were compared in each group. Results:Compared with the model group, the mental state, color of the hair and activity in the observation group were significantly improved, the gross morphology of the femoral head was improved effectively, the bone density was uniform, and the femoral head was smooth, trabecular bone was clear; After model replication, the bone mineral density (BMD), serum phosphorus and calcium levels in the observation group were significantly higher than those in the model group (P<0. 05). The levels of serum phosphorus and calcium in the observation group were significantly higher than those in the model group (P<0.05), and the levels of VEGF in the observation group were significantly higher than those in the model group (P<0. 05). The levels of plasma PT and t-PA, serum TCH and LDL in the observation group were significantly lower than those in the model group (P<0. 05). Conclusion:Anticoagulant therapy combined with lipid-lowering in the treatment of steroid-induced femoral head necrosis can have a significant effect through the mechanism of lowering lipid and anticoagulation to improve blood circulation, promote blood vessel regeneration and bone cell growth.

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