【摘要】 目的 觀察聯合用藥預防激素性股骨頭壞死對血漿NO含量的影響，探討聯合用藥預防的作用機制。方法 30只兔隨機分成三組：對照組同期肌內注射生理鹽水；激素組是給予糖皮質激素肌注；治療組在給予同劑量糖皮質激素同時，每日使用血塞通、脂必妥和阿侖膦酸鈉；觀察股骨頭組織學變化，用免疫組化技術檢測血漿NO含量的變化。結果 激素組股骨頭軟骨下骨小樑稀疏、斷裂，脂肪細胞直徑增大，空骨陷窩較多，血漿NO含量顯著低於對照組；治療組股骨頭軟骨下骨小樑結構較正常，血漿NO含量顯著高於激素組。結論 聯合應用血塞通、脂必妥和阿侖膦酸鈉能預防和減緩激素性股骨頭的發生，血漿NO含量升高是聯合用藥預防的作用途徑之一。?
【關鍵詞】糖皮質激素；股骨頭壞死；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 rtment 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 ods Thirty rabbits were divided randomly into 3 groups:group A,guoup B and group its 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 opathological structure and the content of nitric oxide in plasma were lts 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 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 lusion 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
激素性股骨頭壞死的.發病率佔非創傷性股骨頭壞死首位，並有增高趨勢，已引起廣泛的重視。但目前關於激素性股骨頭缺血性壞死的研究多集中在治療已形成的壞死，對在使用激素過程中如何預防股骨頭壞死，研究較少[1]。本課題組在建立激素性股骨頭壞死動物模型的過程中，採用血塞通、脂必妥和阿侖膦酸鈉聯合用藥進行預防性治療，結果證實聯合用藥預防可提高股骨頭血流量，改善骨組織結構和血液流變學指標，預防或減緩激素性股骨頭壞死[2，3]。本實驗是進一步觀察聯合用藥對血漿一氧化氮(nitric oxide，NO)含量的影響，探討聯合用藥預防激素性股骨頭壞死的作用機制。
1 材料和方法
1.1 實驗動物 成年紐西蘭大白兔30只，不分雌雄，體質量(2.5