细胞膜微粒与兔激素性股骨头缺血坏死发生机制及药物干预的实验研究
|
摘要
【目的】探讨在激素诱发血液高凝、易栓状态导致的股骨头缺血坏死发病过程中,内皮细胞和血小板源性膜微粒的数量以及炎症指标变化。同时在给予干预药物情况下,观察上述膜微粒的数量变化、凝血及炎症指标的改善情况。
【方法】健康成年新西兰兔27只,随机分为3组:A组为对照组(n=9),给予与实验组相同剂量的生理盐水肌注1次;B组为实验组(n=10),给予甲泼尼龙20mg/kg肌注射1次;C组为干预组(n=8),连续给予干预药物2.13 g/kg灌胃12天,于灌胃第7天时给予甲泼尼龙20mg/kg肌注射1次。于注射前、注射后1天、3天、7天、14天和28天各抽静脉全血。使用流式细胞仪对CD31+/CD42b-和CD31+/CD42b+的膜微粒进行定量测定。使用Array-ELISA方法测定TNF-α和IL-1β。同时测定抗凝血酶-Ⅲ(AT-Ⅲ)、蛋白C(PC)、纤维蛋白原(FIB)。于第4周时,处死B组3只动物,取双侧股骨头组织学检查,HE染色。
【结果】给予激素肌注后,CD31+/cD42b-和CD31+/CD42b+的膜微粒显著升高(p＜0.05),分别在7天和14天达峰。而干预组的膜微粒在激素和干预药物的共同作用下虽有波动,但未出现显著差异。给予激素后,B组的PC、ATIII相对于基线出现显著下降,但与对照组比较无显著差异,FIB较基线升高,注射后7天达峰,且高于对照组。而在干预组中,各时间点相对于基线和对照组无显著变化。B组和C组的TNF-α和IL-1β相对于基线表现出不同程度的升高,且均高于对照组。
【结论】应用大剂量糖皮质激素后,兔体内内皮细胞和血小板源性膜微粒数量显著增加,具前凝血潜能的微粒数量的增加可能是大剂量糖皮质激素诱发血液高凝易栓、导致股骨头缺血坏死发生的原因之一。膜微粒直接或间接所致的炎症反应也在股骨头坏死的发生中起到重要作用。干预药物能够抑制微粒的产生,或许有助于预防或避免激素诱发股骨头缺血坏死的发生。
Objective:To investigate the alterations of endothelial- and platelet-derived microparticles and the change of coagulation and inflammation in the steroid-induced avascular osteonecrosis of femoral head with/without an intervention agent.
Method:Twenty-seven healthy New Zealand rabbits were included and randomized into 3 group:Group A(the control group,n=9) would be injected once intramuscularly with the same dose of 0.9%NaCl solution as the steroid group;Group B(the steroid group,n=10) would be injected once intramuscularly with 20 mg/kg of methylprednisolone;Group C(the intervention group,n=8) would receive a intervention agent continuously for 12 days and a injection of 20 mg/kg methylprednisolone once intramuscularly on the day 7 of intervention.The blood sample should be collected before injection of methylprednisolone and day 1,day 3, day 7,day 14 and day 28 after the injection.The microparticles expressing CD31+/CD42b-and CD31+/CD42b+ would be measured using flow cytometry.And the antithrombin-Ⅲ(AT-Ⅲ),protein C(PC) and fibrinogen(FIB) were also examined. Tumor necrosis factor alpfa(TNF-α) and interleukin 1 beta(IL-1β) would be measured using Array-ELISA.Three rabbits from the steroid group were sacrificed and their femoral heads were taken out to undergo histopathologic examination with HE staining in 4 weeks after the injection.
Results:The AT-Ⅲ,PC levels decreased significantly 7 to 28 days and the FIB level increased on day 7 without significance and then decreased slightly after the injection. The numbers of EMP and PMP were also increased markedly after steroid administration.Both TNF-αand IL-1βlevels increased relative to the baseline, and were greater than the control group at each time point,but no significance was observed.No positive finding was observed in the histopathologic examination.
Conclusion:High-dose glucocorticosteroid increases the levels of PMP and EMP that may be related to hypercoagulability,thrombosis and inflammation in microcirculation and play an important role in steroid-induced osteonecrosis.The intervention agent appeared to have the efficacy to decrease the MP levels and improve the hypercoagulability and thrombosis.MP can be considered a true target in the pharmacological control of steroid-induced osteonecrosis.
【方法】健康成年新西兰兔27只,随机分为3组:A组为对照组(n=9),给予与实验组相同剂量的生理盐水肌注1次;B组为实验组(n=10),给予甲泼尼龙20mg/kg肌注射1次;C组为干预组(n=8),连续给予干预药物2.13 g/kg灌胃12天,于灌胃第7天时给予甲泼尼龙20mg/kg肌注射1次。于注射前、注射后1天、3天、7天、14天和28天各抽静脉全血。使用流式细胞仪对CD31+/CD42b-和CD31+/CD42b+的膜微粒进行定量测定。使用Array-ELISA方法测定TNF-α和IL-1β。同时测定抗凝血酶-Ⅲ(AT-Ⅲ)、蛋白C(PC)、纤维蛋白原(FIB)。于第4周时,处死B组3只动物,取双侧股骨头组织学检查,HE染色。
【结果】给予激素肌注后,CD31+/cD42b-和CD31+/CD42b+的膜微粒显著升高(p＜0.05),分别在7天和14天达峰。而干预组的膜微粒在激素和干预药物的共同作用下虽有波动,但未出现显著差异。给予激素后,B组的PC、ATIII相对于基线出现显著下降,但与对照组比较无显著差异,FIB较基线升高,注射后7天达峰,且高于对照组。而在干预组中,各时间点相对于基线和对照组无显著变化。B组和C组的TNF-α和IL-1β相对于基线表现出不同程度的升高,且均高于对照组。
【结论】应用大剂量糖皮质激素后,兔体内内皮细胞和血小板源性膜微粒数量显著增加,具前凝血潜能的微粒数量的增加可能是大剂量糖皮质激素诱发血液高凝易栓、导致股骨头缺血坏死发生的原因之一。膜微粒直接或间接所致的炎症反应也在股骨头坏死的发生中起到重要作用。干预药物能够抑制微粒的产生,或许有助于预防或避免激素诱发股骨头缺血坏死的发生。
Objective:To investigate the alterations of endothelial- and platelet-derived microparticles and the change of coagulation and inflammation in the steroid-induced avascular osteonecrosis of femoral head with/without an intervention agent.
Method:Twenty-seven healthy New Zealand rabbits were included and randomized into 3 group:Group A(the control group,n=9) would be injected once intramuscularly with the same dose of 0.9%NaCl solution as the steroid group;Group B(the steroid group,n=10) would be injected once intramuscularly with 20 mg/kg of methylprednisolone;Group C(the intervention group,n=8) would receive a intervention agent continuously for 12 days and a injection of 20 mg/kg methylprednisolone once intramuscularly on the day 7 of intervention.The blood sample should be collected before injection of methylprednisolone and day 1,day 3, day 7,day 14 and day 28 after the injection.The microparticles expressing CD31+/CD42b-and CD31+/CD42b+ would be measured using flow cytometry.And the antithrombin-Ⅲ(AT-Ⅲ),protein C(PC) and fibrinogen(FIB) were also examined. Tumor necrosis factor alpfa(TNF-α) and interleukin 1 beta(IL-1β) would be measured using Array-ELISA.Three rabbits from the steroid group were sacrificed and their femoral heads were taken out to undergo histopathologic examination with HE staining in 4 weeks after the injection.
Results:The AT-Ⅲ,PC levels decreased significantly 7 to 28 days and the FIB level increased on day 7 without significance and then decreased slightly after the injection. The numbers of EMP and PMP were also increased markedly after steroid administration.Both TNF-αand IL-1βlevels increased relative to the baseline, and were greater than the control group at each time point,but no significance was observed.No positive finding was observed in the histopathologic examination.
Conclusion:High-dose glucocorticosteroid increases the levels of PMP and EMP that may be related to hypercoagulability,thrombosis and inflammation in microcirculation and play an important role in steroid-induced osteonecrosis.The intervention agent appeared to have the efficacy to decrease the MP levels and improve the hypercoagulability and thrombosis.MP can be considered a true target in the pharmacological control of steroid-induced osteonecrosis.
引文
1.孙伟:股骨头坏死的病因、病理和发病机制。中华全科医师杂志,2006,5(2):75-77
2.Saito S,Ohzon K,Keiro.Early arteriopathy and postulated pathogenesis of osteonecrosis of the femoral head.Clin O rthop,1992,277:98
3.Glueck CJ,Freiberg RA,Wang P.Role of thrombosis in osteonecrosis.Curr Hematol Rep,2003,2:4172422.
4.Glueck CJ,Freiberg RA,Sieve L,et al.Enoxaparin prevents progression of stages Ⅰ and Ⅱ osteonecrosis of the hip.Clin Orthop Relat Res,2005,(435):1642170.
5.MontMA,Hungerfo rd DS1Nom traumatic avascular necrosis of femoral head[J]J Bone Joint Surg Am,1995,77(3):4591.
6.Sternberg ME.Larcom PG,Strafford B,et al.Core decompression with bone grafting for osteonecrosis of the femoral head[J].Clin Orthop,2001,386(5):71278.
7.Wood ML,McDowell CM,Kerstetter TL,et al.Open reduction and cementation for femoral head fracture secondary to avascular necrosis:preliminary report[J].Iowa Orthop J,2000,20:17223.
8.曾述强,葛宝丰,文益民.Trapdoor手术治疗股骨头缺血性坏死[J].骨与关节损伤杂志,2003,18(3):1752176.
9.Soucacos PN,Urbaniak JR.Osteonecrosis of the human skelton[J]Orthop Clin North Am,2004,35(3):13215.
10.曹殿波,杨海山,赵永生,等.成人股骨头缺血坏死介入治疗的临床疗效分析[J].白求恩医科大学学报,2001,27(5):529,531.
11.Fyda TM,Callaghan JJ,Olejniczak J,et al.Minimum ten-year follow-up of cemented total hip replacement in patients with osteonecrosis of the femoral head[J].Iowa Orthop,2002,22(4):8219.
12.Garino JP,Steinberg ME.Total hip arthroplasty in patient with avascular necrosis of the femoral head[J].Clin Orthop,1997,334(1):108-115
13.Russo S,Gigliotti O,Gigliotti S,et al.Shockwave therapy[M].1st ed.London:Greenwich Medical Ltd,200012312240.
14.Goro Motomura,Takuaki Yamamoto,et al.Combined effects of an anticoagulant and a lipid-lowering agent on the prevention of steroid-induced osteonecrosis in rabbits.ARTHRITIS & RHEUMATISM.Vol.50,No.10,October 2004,pp 3387-3391.
15.刘亚梅,葛喜珍.骨复活汤对实验性激素性股骨头坏死的干预作用[J].河北医科大学学报,2005,26(6):698-699.
16.李毅,赤阳泉,朱超等.骨复生对激素性股骨头缺血性坏死家兔血浆一氧化氮的影响[J].中医正骨,2002,14(7):8-9.
17.《中国药典》2005年版一部-470页。
18.Mack M,Kleinschmidt A,Bruhl H,et al:Transfer of the chemokine receptor CCR5 between cells by membrane-derived microparticles:A mechanism for cellular human immunodeficiency virus infection.Nat Med,2000,6:769-775.
19.Preston RA,Jy W,Jimenez JJ,Mauro LM,Horstman LL,Valle M et al.Effects of severe hypertension on endothelial and platelet microparticles.Hypertension 2003;41:211-7.
20.Roque B,Arteaga,Julio A,et al.Endothelial Microparticles and Platelet and Leukocyte Activation in Patients with the Metabolic Syndrome.American Journal of Cardiology,2006,98:70-74.
21.Andres O,Wenche Jy,Julio A,et al.Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis.Crit Care Med,2005,33:2540-2546.
22.Jones JP.Fat embolism and asteon ecmsis.Orthop Olin North Am,1985,16:595-633.
23.Olivier M,Florence T,Benedicte H.et al.Cellular microparticles:a disseminated storage pool of bioactive vascular efects.Hematology,2004,11:156-164.
24.Nieuwland R.Berckmans RJ,Rotteveel-Ei jkman RC,et al.Cell-derived microparticles generated in patients during cardiopulmonary bypass are highly procoagulant.Circulation.1997.96:3534-3541.
25.Craft J,Masei PP,RObert MS,et al.Increased platelet-derived micmpardcles in the coronary circulation of pereutaneous transluminal coronary angioplasty patients.Blood Coagulation and Fibinolysis.2004,15:475-482.
26. Craft J, Maesh NA. Increased generation of platelet-derived microparticles folowed transluminal coronary angiology. Blood Coagulation and Fibinolysis, 2003, 14: 719-728.
27. Diamant ME, Tushuizen AS, Nieuwland R. Celular Microparticles: new players in the field of vascular disease? Eur J Clini Investigation, 2004, 34: 391-401.
28. Atkinson B, Dwyer K, Enjyoji K, et al. Ecto-nucleotidases of the CD39 /NTPDase family modulate platelet activation and thrombus formation: potential as therapeutic targets. Blood Cells Mol Dis. 2006. 10: 289-296.
29. Engelmann B. Initiation of coagulation by tissue factor carriers in blood. Blood Cells Mol Dis, 2006, 10: 281-286.
30. Van der Z, Biro E, Ko Y, et al. Detection of activated platelets in canine blood by use of flow cytometry. Am J Res, 2006, 67: 56-63.
31. Pcreira J, Alfaro G, Goycoolea M, et al. Circulating platelet-derived microparticles in systemic lupus erythematosus Association with increased thrombin generation and procoagulant state. Thromb Haemost, 2006, 95: 94-99.
32. Suttirengwong S, Rolker J, Sminova AW , et al. Hyperbranched polymers as drug carriers: microencapsulation and release kinetics. Pharm Dev Technol. 2006. 11: 55-70.
33. Mesri M, Altieri DC. Leukocyte microparticles stimulate endothelial cell cytokine release and tissue factor induction in JNK1 signaling pathway. J Biol Chem 1999;274:23111 - 8.
34. Barry OP, Pratico D, Lawson JA, FitzGerald GA. Transcellular activation of platelets and endothelial cells by bioactive lipids in platelet microparticles. J Clin Invest 1997;99:2118 - 27.
35. Barry OP, Pratico D, Savani RC, FitzGerald GA. Modulation of monocyte - endothelial cell interactions by platelet microparticles. J Clin Invest 1998;102:136 - 44.
1.韩永台,米立新,李欣,等.分米波对股骨头缺血性坏死影响的实验研究[J].中华理疗杂志,1998,21(4):20922121
2.Well L SJ,Roukis TS,Weil LS,et al.Extracorporeal shock wave therapy for the treatment of chronic plantarfasciitis:indications,protocol,intermediate results,and a comparison of results to fasciotomy[J].J Foot Ankle Surg,2002,41(3):16621721
3.肖军,杨述华.体外冲击波治疗股骨头缺血性坏死[J].国外医学:骨科学分册,2005,26(1):262281
4.Ludwig J,Lauber HJ,Lauber S,et al.High-energy shock wave treatment of femoral head necrosis in adults[J].Clin Orthop Relat Res,2001,21(387):11921261
5.孙强三,孙昭辉,王晓红,等1超短波早期治疗激素性股骨头缺血性坏死的实验研究[J].中华物理医学与康复杂志,2004,26(12):72927311
6.梁君奎,姜西良,张秀林,等.介入加注射治疗激素性股骨头坏死112例临床观察[J].河北医科大学学报,2000,21(2):832841
7.刘林英,刘贺.放射介入治疗股骨头坏死的体会[J].中国疗养医学,2001,10(6):262271
8.叶建红,毛向东.股骨头缺血性坏死的基因治疗展望[J].华南国防医学杂志,2004,18(5):282291
9.Mont MA,Hungerford DS.Non traumatic avascular necrosis of femoral head[J].J Bone Joint Surg Am,1995,77(3):459.
10.Bozic KJ,Zurakow ski D,Thornhill TS.Survivorship analysis of hips treated with core decompression for nontraumatic osteonecrosis of the femoral head[J].J Bone Joint Surg Am,1999,81(2):20022091
11.何伟,袁浩.多条血管束植入治疗成人股骨头坏死的远期疗效观察[J]. 骨与关节损伤杂志, 2000, 15 (4) : 26122631
12. Duchow J , Kubale, Hopf T. Color Dopplerimaging assessment of blood flow in vascularized pedicle grafts for avascular necrosis of the femoral head: angiographic correlation [J]. J Ultrasound Med, 1998, 17 (8) : 50925121
13. 袁浩, 陈基长,何振辉, 等1 多条血管束植入治疗成人股骨头缺血性坏死[J ]1 中华骨科杂志, 1992, 12 (5) : 35723581
14.Leung PC. Femoral head reconstruction and revascularization treatment forischemic necrosis [J]. Clin Orthop, 1996, 381 (6) : 1391
15. Xenakis TA , Gelalis J , Koukoubis TA , et al. Cementless hip arthroplasty in the treatment of patients with femoral head necrosis[J]. Clin Orthop, 2001, 386 (5): 932991
16. Thornhill TS. A lternatives to total hip arthroplasty in osteonecrosis of the femoral head[J]. Orthopedics, 2001, 24 (9) : 861-863.
17. Garino JP ,Steinberg ME. Total hip arthroplasty in patient with avascular necrosis of the femoral head[J]. Clin Orthop,1997 ,334(1) :108-115
18. Russo S, Gigliotti O, Gigliotti S, et al. Shockwave therapy[M]. 1st ed. London: Greenwich Medical Ltd, 200012312240.
19. Sternberg ME. Larcom PG, Strafford B, et al. Core decompression with-bone grafting for osteonecrosis of the femoral head[J] . Clin Orthop ,2001 ,386 (5) : 71278.
20. Sugioka Y, Hotokebuchi T, Tsutsui H. Transtrochanteric anterior rotational osteotomy for idiopathic and steroidinduced necrosis of the femoral head. Judications and longterm results[J]. Clin Orthop ,1992 ,277(4) : 1112120.
21.Atsumi T, Muraki M, Yoshihara S, et al . Posterior rotational osteotomy for thetreatment of femoral head osteonecrosis [J ] . Arch Orthop Trauma Surg ,1999 ,119 (728) :3882393.
22. Gallinaro P , Masse A. Flexion osteotomy in the treatment of avascular necrosis of the hip[J ] . Clin Orthop Relat Res , 2001 , (386) :79284.
23. Nakai T , Masuhara K,Nakase T , et al . Pathology of femoral head collapse[J ] . Arch Orthop Trauma Surg ,2000 ,120 (9) :4892492.
24.Hernigou P,bachir D,Galactcros F.Avascular necrosis of the femoral head in sickle cell disease.Treatment of collapse by the injection of acrylic cement[J].J Bone Joint Surg Br,1993,75(6):8752880.
25.Wood ML,McDowell CM,Kerstetter TL,et al.Open reduction and cementation for femoral head fracture secondary to avascular necrosis:preliminary report[J].Iowa Orthop J,2000,20:17223.
26.王岩,王继芳,卢世璧,等.网球支架置人治疗股骨头缺血性坏死[J].中华骨科杂志,2000,20(5):2952298.
27.董天华,刘松,朱国梁,等.羟基磷灰石骨水泥植入治疗成人股骨头缺血性坏死的中期疗效观察[J].中华骨科杂志,2002,22(2):84,87.
28.徐小良,王坤正,杨增华,等.Bbmp2胶元2珊瑚复合人工骨修复股骨头缺损的生物力学研究[J].中国骨伤,2001,14(1):17219.
29.曾述强,葛宝丰,文益民.Trapdoor手术治疗股骨头缺血性坏死[J].骨与关节损伤杂志,2003,18(3):1752176.
30.Judet H,Gilbert A.Long2term results of free vascularized fibulfir grafting for femoral head necrosis[J].Clin Onhop,2001,386(5):1142119.
31.Soucacos PN,Urbaniak JR.Osteonecrsis of the human skelton[J].Orthop Clin North Am,2004,35(3):13215.
32.Leung PC.Femoral head reconstruction and revascularization.Treatment forischemic necrosis[J].Clin Orthop,1996,323(2):1392145.
33.Pavlovcic,Do linar D,Arnez G.Femoral head necrosis treated with vascularized iliac crest graft[J]Int Orthop,1999,23(3):1502153.
34.Hasegawa Y.Vascularized pedicle bone2grafting for nontraumatic avascular necrosis of the femoral head[J].Arch Orthop Trauma Surg,1997,116(5):2512258.
35.Xenakis TA,Gelalis J,Koukoubis TA,et al.Cementless hip arthroplasty in the treatment of patients with femoral head necrosis[J].Clin Orthop,2001,386(5):93299.
36.Fyda rM,Callaghan JJ,Ole jniczak J,et al.Minimum ten-year follow-up of cemented total hip replacement in patients with osteonecrosis of the femoral head[J].Iowa Orthop,2002,22(4):8219.
2.Saito S,Ohzon K,Keiro.Early arteriopathy and postulated pathogenesis of osteonecrosis of the femoral head.Clin O rthop,1992,277:98
3.Glueck CJ,Freiberg RA,Wang P.Role of thrombosis in osteonecrosis.Curr Hematol Rep,2003,2:4172422.
4.Glueck CJ,Freiberg RA,Sieve L,et al.Enoxaparin prevents progression of stages Ⅰ and Ⅱ osteonecrosis of the hip.Clin Orthop Relat Res,2005,(435):1642170.
5.MontMA,Hungerfo rd DS1Nom traumatic avascular necrosis of femoral head[J]J Bone Joint Surg Am,1995,77(3):4591.
6.Sternberg ME.Larcom PG,Strafford B,et al.Core decompression with bone grafting for osteonecrosis of the femoral head[J].Clin Orthop,2001,386(5):71278.
7.Wood ML,McDowell CM,Kerstetter TL,et al.Open reduction and cementation for femoral head fracture secondary to avascular necrosis:preliminary report[J].Iowa Orthop J,2000,20:17223.
8.曾述强,葛宝丰,文益民.Trapdoor手术治疗股骨头缺血性坏死[J].骨与关节损伤杂志,2003,18(3):1752176.
9.Soucacos PN,Urbaniak JR.Osteonecrosis of the human skelton[J]Orthop Clin North Am,2004,35(3):13215.
10.曹殿波,杨海山,赵永生,等.成人股骨头缺血坏死介入治疗的临床疗效分析[J].白求恩医科大学学报,2001,27(5):529,531.
11.Fyda TM,Callaghan JJ,Olejniczak J,et al.Minimum ten-year follow-up of cemented total hip replacement in patients with osteonecrosis of the femoral head[J].Iowa Orthop,2002,22(4):8219.
12.Garino JP,Steinberg ME.Total hip arthroplasty in patient with avascular necrosis of the femoral head[J].Clin Orthop,1997,334(1):108-115
13.Russo S,Gigliotti O,Gigliotti S,et al.Shockwave therapy[M].1st ed.London:Greenwich Medical Ltd,200012312240.
14.Goro Motomura,Takuaki Yamamoto,et al.Combined effects of an anticoagulant and a lipid-lowering agent on the prevention of steroid-induced osteonecrosis in rabbits.ARTHRITIS & RHEUMATISM.Vol.50,No.10,October 2004,pp 3387-3391.
15.刘亚梅,葛喜珍.骨复活汤对实验性激素性股骨头坏死的干预作用[J].河北医科大学学报,2005,26(6):698-699.
16.李毅,赤阳泉,朱超等.骨复生对激素性股骨头缺血性坏死家兔血浆一氧化氮的影响[J].中医正骨,2002,14(7):8-9.
17.《中国药典》2005年版一部-470页。
18.Mack M,Kleinschmidt A,Bruhl H,et al:Transfer of the chemokine receptor CCR5 between cells by membrane-derived microparticles:A mechanism for cellular human immunodeficiency virus infection.Nat Med,2000,6:769-775.
19.Preston RA,Jy W,Jimenez JJ,Mauro LM,Horstman LL,Valle M et al.Effects of severe hypertension on endothelial and platelet microparticles.Hypertension 2003;41:211-7.
20.Roque B,Arteaga,Julio A,et al.Endothelial Microparticles and Platelet and Leukocyte Activation in Patients with the Metabolic Syndrome.American Journal of Cardiology,2006,98:70-74.
21.Andres O,Wenche Jy,Julio A,et al.Levels of endothelial and platelet microparticles and their interactions with leukocytes negatively correlate with organ dysfunction and predict mortality in severe sepsis.Crit Care Med,2005,33:2540-2546.
22.Jones JP.Fat embolism and asteon ecmsis.Orthop Olin North Am,1985,16:595-633.
23.Olivier M,Florence T,Benedicte H.et al.Cellular microparticles:a disseminated storage pool of bioactive vascular efects.Hematology,2004,11:156-164.
24.Nieuwland R.Berckmans RJ,Rotteveel-Ei jkman RC,et al.Cell-derived microparticles generated in patients during cardiopulmonary bypass are highly procoagulant.Circulation.1997.96:3534-3541.
25.Craft J,Masei PP,RObert MS,et al.Increased platelet-derived micmpardcles in the coronary circulation of pereutaneous transluminal coronary angioplasty patients.Blood Coagulation and Fibinolysis.2004,15:475-482.
26. Craft J, Maesh NA. Increased generation of platelet-derived microparticles folowed transluminal coronary angiology. Blood Coagulation and Fibinolysis, 2003, 14: 719-728.
27. Diamant ME, Tushuizen AS, Nieuwland R. Celular Microparticles: new players in the field of vascular disease? Eur J Clini Investigation, 2004, 34: 391-401.
28. Atkinson B, Dwyer K, Enjyoji K, et al. Ecto-nucleotidases of the CD39 /NTPDase family modulate platelet activation and thrombus formation: potential as therapeutic targets. Blood Cells Mol Dis. 2006. 10: 289-296.
29. Engelmann B. Initiation of coagulation by tissue factor carriers in blood. Blood Cells Mol Dis, 2006, 10: 281-286.
30. Van der Z, Biro E, Ko Y, et al. Detection of activated platelets in canine blood by use of flow cytometry. Am J Res, 2006, 67: 56-63.
31. Pcreira J, Alfaro G, Goycoolea M, et al. Circulating platelet-derived microparticles in systemic lupus erythematosus Association with increased thrombin generation and procoagulant state. Thromb Haemost, 2006, 95: 94-99.
32. Suttirengwong S, Rolker J, Sminova AW , et al. Hyperbranched polymers as drug carriers: microencapsulation and release kinetics. Pharm Dev Technol. 2006. 11: 55-70.
33. Mesri M, Altieri DC. Leukocyte microparticles stimulate endothelial cell cytokine release and tissue factor induction in JNK1 signaling pathway. J Biol Chem 1999;274:23111 - 8.
34. Barry OP, Pratico D, Lawson JA, FitzGerald GA. Transcellular activation of platelets and endothelial cells by bioactive lipids in platelet microparticles. J Clin Invest 1997;99:2118 - 27.
35. Barry OP, Pratico D, Savani RC, FitzGerald GA. Modulation of monocyte - endothelial cell interactions by platelet microparticles. J Clin Invest 1998;102:136 - 44.
1.韩永台,米立新,李欣,等.分米波对股骨头缺血性坏死影响的实验研究[J].中华理疗杂志,1998,21(4):20922121
2.Well L SJ,Roukis TS,Weil LS,et al.Extracorporeal shock wave therapy for the treatment of chronic plantarfasciitis:indications,protocol,intermediate results,and a comparison of results to fasciotomy[J].J Foot Ankle Surg,2002,41(3):16621721
3.肖军,杨述华.体外冲击波治疗股骨头缺血性坏死[J].国外医学:骨科学分册,2005,26(1):262281
4.Ludwig J,Lauber HJ,Lauber S,et al.High-energy shock wave treatment of femoral head necrosis in adults[J].Clin Orthop Relat Res,2001,21(387):11921261
5.孙强三,孙昭辉,王晓红,等1超短波早期治疗激素性股骨头缺血性坏死的实验研究[J].中华物理医学与康复杂志,2004,26(12):72927311
6.梁君奎,姜西良,张秀林,等.介入加注射治疗激素性股骨头坏死112例临床观察[J].河北医科大学学报,2000,21(2):832841
7.刘林英,刘贺.放射介入治疗股骨头坏死的体会[J].中国疗养医学,2001,10(6):262271
8.叶建红,毛向东.股骨头缺血性坏死的基因治疗展望[J].华南国防医学杂志,2004,18(5):282291
9.Mont MA,Hungerford DS.Non traumatic avascular necrosis of femoral head[J].J Bone Joint Surg Am,1995,77(3):459.
10.Bozic KJ,Zurakow ski D,Thornhill TS.Survivorship analysis of hips treated with core decompression for nontraumatic osteonecrosis of the femoral head[J].J Bone Joint Surg Am,1999,81(2):20022091
11.何伟,袁浩.多条血管束植入治疗成人股骨头坏死的远期疗效观察[J]. 骨与关节损伤杂志, 2000, 15 (4) : 26122631
12. Duchow J , Kubale, Hopf T. Color Dopplerimaging assessment of blood flow in vascularized pedicle grafts for avascular necrosis of the femoral head: angiographic correlation [J]. J Ultrasound Med, 1998, 17 (8) : 50925121
13. 袁浩, 陈基长,何振辉, 等1 多条血管束植入治疗成人股骨头缺血性坏死[J ]1 中华骨科杂志, 1992, 12 (5) : 35723581
14.Leung PC. Femoral head reconstruction and revascularization treatment forischemic necrosis [J]. Clin Orthop, 1996, 381 (6) : 1391
15. Xenakis TA , Gelalis J , Koukoubis TA , et al. Cementless hip arthroplasty in the treatment of patients with femoral head necrosis[J]. Clin Orthop, 2001, 386 (5): 932991
16. Thornhill TS. A lternatives to total hip arthroplasty in osteonecrosis of the femoral head[J]. Orthopedics, 2001, 24 (9) : 861-863.
17. Garino JP ,Steinberg ME. Total hip arthroplasty in patient with avascular necrosis of the femoral head[J]. Clin Orthop,1997 ,334(1) :108-115
18. Russo S, Gigliotti O, Gigliotti S, et al. Shockwave therapy[M]. 1st ed. London: Greenwich Medical Ltd, 200012312240.
19. Sternberg ME. Larcom PG, Strafford B, et al. Core decompression with-bone grafting for osteonecrosis of the femoral head[J] . Clin Orthop ,2001 ,386 (5) : 71278.
20. Sugioka Y, Hotokebuchi T, Tsutsui H. Transtrochanteric anterior rotational osteotomy for idiopathic and steroidinduced necrosis of the femoral head. Judications and longterm results[J]. Clin Orthop ,1992 ,277(4) : 1112120.
21.Atsumi T, Muraki M, Yoshihara S, et al . Posterior rotational osteotomy for thetreatment of femoral head osteonecrosis [J ] . Arch Orthop Trauma Surg ,1999 ,119 (728) :3882393.
22. Gallinaro P , Masse A. Flexion osteotomy in the treatment of avascular necrosis of the hip[J ] . Clin Orthop Relat Res , 2001 , (386) :79284.
23. Nakai T , Masuhara K,Nakase T , et al . Pathology of femoral head collapse[J ] . Arch Orthop Trauma Surg ,2000 ,120 (9) :4892492.
24.Hernigou P,bachir D,Galactcros F.Avascular necrosis of the femoral head in sickle cell disease.Treatment of collapse by the injection of acrylic cement[J].J Bone Joint Surg Br,1993,75(6):8752880.
25.Wood ML,McDowell CM,Kerstetter TL,et al.Open reduction and cementation for femoral head fracture secondary to avascular necrosis:preliminary report[J].Iowa Orthop J,2000,20:17223.
26.王岩,王继芳,卢世璧,等.网球支架置人治疗股骨头缺血性坏死[J].中华骨科杂志,2000,20(5):2952298.
27.董天华,刘松,朱国梁,等.羟基磷灰石骨水泥植入治疗成人股骨头缺血性坏死的中期疗效观察[J].中华骨科杂志,2002,22(2):84,87.
28.徐小良,王坤正,杨增华,等.Bbmp2胶元2珊瑚复合人工骨修复股骨头缺损的生物力学研究[J].中国骨伤,2001,14(1):17219.
29.曾述强,葛宝丰,文益民.Trapdoor手术治疗股骨头缺血性坏死[J].骨与关节损伤杂志,2003,18(3):1752176.
30.Judet H,Gilbert A.Long2term results of free vascularized fibulfir grafting for femoral head necrosis[J].Clin Onhop,2001,386(5):1142119.
31.Soucacos PN,Urbaniak JR.Osteonecrsis of the human skelton[J].Orthop Clin North Am,2004,35(3):13215.
32.Leung PC.Femoral head reconstruction and revascularization.Treatment forischemic necrosis[J].Clin Orthop,1996,323(2):1392145.
33.Pavlovcic,Do linar D,Arnez G.Femoral head necrosis treated with vascularized iliac crest graft[J]Int Orthop,1999,23(3):1502153.
34.Hasegawa Y.Vascularized pedicle bone2grafting for nontraumatic avascular necrosis of the femoral head[J].Arch Orthop Trauma Surg,1997,116(5):2512258.
35.Xenakis TA,Gelalis J,Koukoubis TA,et al.Cementless hip arthroplasty in the treatment of patients with femoral head necrosis[J].Clin Orthop,2001,386(5):93299.
36.Fyda rM,Callaghan JJ,Ole jniczak J,et al.Minimum ten-year follow-up of cemented total hip replacement in patients with osteonecrosis of the femoral head[J].Iowa Orthop,2002,22(4):8219.