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背景:皮质类固醇激素性骨坏死是造成髋关节功能丧失的主要病因之一。近年研究表明,激素性股骨头坏死可能与激素引起的骨髓间充质干细胞增殖能力有关。目的:检测皮质类固醇性骨坏死患者骨髓间充质干细胞的增殖活性,为建立自体骨髓干细胞移植治疗股骨头坏死的合理性寻求证据。方法:选取皮质类固醇性股骨头坏死病例设为股骨头坏死组,按取材部位不同再分为股骨头坏死股骨头组、股骨头坏死髂骨组,同时选取无股骨头坏死、无激素应用的拟行人工关节置换的股骨颈骨折患者设为对照组。用密度梯度离心法分离各组骨髓间充质干细胞,再经贴壁筛选法筛选,选取第3代细胞进行实验。结果与结论:MTT结果显示,股骨头坏死股骨头组增殖能力明显弱于其他2组,其骨髓间充质干细胞在培养后1-7 d为生长滞留期,第8天达到对数生长期,以后进入到平台期,而其他2组较病例组生长曲线明显前移,并且峰值增高。流式细胞仪测定的细胞周期结果显示,股骨头坏死股骨头组中G0/G1细胞比例明显增高,而S+G2/M期细胞比例降低,细胞增殖指数较其他2组降低(P<0.05),而股骨头坏死髂骨组的细胞增殖活性最强。结果证实,皮质类固醇性骨坏死患者股骨头来源的骨髓间充质干细胞增殖活性较低,髂骨来源的骨髓间充质干细胞活性增殖活性较高。
BACKGROUND: Corticosteroid-induced osteonecrosis is one of the major causes of hip dysfunction. Recent studies have shown that steroid-induced necrosis of femoral head may be related to hormone-induced proliferation of bone marrow-derived mesenchymal stem cells. OBJECTIVE: To detect the proliferation activity of bone marrow mesenchymal stem cells in patients with corticosteroid-induced osteonecrosis and to find evidence for establishing the rationality of autologous bone marrow stem cell transplantation in the treatment of femoral head necrosis. Methods: The cases of corticosteroid-induced necrosis of the femoral head were selected as the group of femoral head necrosis, and then divided into the femoral head necrosis femoral head group and the femoral head necrosis iliac bone group according to the different parts of the femoral head necrosis. At the same time, no femoral head necrosis and no hormone application Femoral neck fractures treated with artificial joint replacement were set as control group. The bone marrow mesenchymal stem cells were separated by density gradient centrifugation and then screened by adherence screening method. The third generation of cells were selected for experiment. RESULTS AND CONCLUSION: MTT results showed that the femoral head group of femoral head necrosis was significantly weaker than the other two groups. The bone marrow mesenchymal stem cells grew in the first 7 days and reached the logarithmic growth phase on the 8th day, After entering the platform period, while the other two groups than the case group growth curve significantly forward, and the peak increased. The results of flow cytometry showed that the proportion of G0 / G1 cells in the femoral head group was significantly higher than that in the other two groups (P <0.05), while the proportion of cells in S + G2 / M phase was decreased , While the femoral head necrosis iliac group cell proliferation activity strongest. The results confirmed that patients with corticosteroid osteonecrosis femoral head derived bone marrow mesenchymal stem cell proliferation activity is low, iliac bone marrow-derived mesenchymal stem cell proliferation activity was higher.