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Investigation of the pathogenesis of steroid-induced osteonecrosis and its prevention

激素性骨坏死的发病机制及其预防研究

基本信息

批准号：
15591587
负责人：
YAMAMOTO Takuaki
金额：
$ 2.24万
依托单位：
KYUSHU UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-15591587/
关键词：
osteonecrosis steroid prevention femoral head lipid metabolism coagulation insufficiency fracture pathology 大腿骨折

项目摘要

1 Prevention of steroid-induced osteonecrosis using animal modelsWe investigated the effects of the combination treatment with an anticoagulant (warfarin) plus a lipid-lowering agent (probucol) on prevention of steroid-induced osteonecrosis (ON) in rabbits. The incidence of ON in the WP group (5%) was significantly lower than that observed in the NP group (70%) (p<0.0001). While the incidences of ON in the PA and WA groups (37% and 33%, respectively) were also significantly lower than that seen in the NP group (p<0.05), they were significantly higher than that observed in the WP group (p<0.01 and p<0.05, respectively). The sizes of the bone marrow fat cells in both the WP (53.5±4.1 μm) and PA groups (52.0±5.0 μm) were significantly smaller than those in the NP group (60.0±4.0 μm) (p< 0.01). We also observed elongation of prothrombin time and reduced plasma lipid levels in the WP group during the study duration. This study experimentally confirmed that the combined use of an anticoagulant and a lipid-lowering agent helps prevent steroid-induced ON in rabbits.2 The concept of subchondral insufficiency fractureSubchondral insufficiency fracture of the femoral head (SIF) is a recently proposed concept, which needs to be differentiated from osteonecrosis. We investigated its clinicopathological appearance and frequency. SIF should be included in the differential diagnosis of acute onset of coxarthrosis, especially in the elderly female.

1激素性骨坏死动物模型的预防我们研究了抗凝剂（华法林）和降脂剂（普罗布考）联合治疗对家兔激素性骨坏死（ON）的预防作用。WP组的ON发生率（5%）显著低于NP组（70%）（p<0.0001）。PA组和WA组的ON发生率（分别为37%和33%）也显著低于NP组（p<0.05），但显著高于WP组（分别为p<0.01和p<0.05）。WP组和PA组的骨髓脂肪细胞大小（53.5±4.1 μm和52.0±5.0 μm）均明显小于NP组（60.0±4.0 μm）（p< 0.01）。我们还观察到延长凝血酶原时间和降低血脂水平的WP组在研究期间。本研究通过实验证实，抗凝剂和降脂剂的联合使用有助于预防家兔类固醇诱导的ON。2软骨下功能不全的概念股骨头软骨下功能不全骨折（SIF）是最近提出的概念，需要与骨坏死相区分。我们调查了其临床病理表现和频率。SIF应包括在髋关节病急性发作的鉴别诊断，特别是在老年女性。