双膦酸盐联合甲氨喋呤对胶原诱导性关节炎大鼠关节炎症及骨破坏的影响

摘要

目的 探讨双磷酸盐及双磷酸盐联合甲氨喋呤对胶原诱导性关节炎(CIA)大鼠关节炎症、骨破坏的影响.方法 选取2018年3月CIA造模成功且关节炎中度以上的大鼠91只,按照随机数字表分为3组,A组31只,B组、C组各30只.A组:为空白对照组,使用灭菌用水治疗;B组:双磷酸盐治疗;C组:双磷酸盐联合甲氨喋呤治疗.治疗1个月.比较各组关节炎症分值及骨破坏程度差异.结果 治疗前3组炎症分值比较,差异无统计学意义(P>0.05).治疗后第1周、第2周以及治疗结束时C组炎症分值均低于A组和B组,差异均具有统计学意义(P0.05).胫骨上段矢状面松质骨变化:治疗结束A组大鼠胫骨平台前方塌陷,骨骺线向前倾斜,骨骺线下1～4mm次级松质骨骨小梁稀少凌乱.B组与C组骨骺线清晰可见,仍保持正常结构形态,但B组较C组骨小梁数目稀疏,结构排列较C组差.C组骨小梁面积百分数、宽度、数量高于A组和B组,差异均具有统计学意义(P0.05);C组骨小梁分离度低于A组和B组,差异均具有统计学意义(P0.05).结论 双磷酸盐联合甲氨喋呤可抑制CIA大鼠关节炎症反应、关节周围骨丢失以及关节侵蚀,单独使用双磷酸盐无此效果.%Objective To discuss the influence of double phosphonic acid salt combined methotrexate on joint inflammation and bone de-struction in collagen induced arthritis (CIA)rats. Methods 91 CIA rats were divided into 3 groups according to random number table,31 rats in group A and 30 in group B and C. Group A:as the blank control group,were given sterilized water treatment;Group B:double phosphate treatment;Group C:double phosphate with methotrexate therapy. The extent of joint inflammation and bone destruction were compared. Results Inflammation score before treatment in three groups has no statistically significant difference (P>0.05). 1 week,2 weeks after treatment,and treatment of inflammatory score at the end of the C group were lower than those of group A and group B,the differences were statistically significant (P0.05). Tibial sagittal cancellous bone chan-ges:at the end of the treatment,the upper tibia platform collapsed ahead,epiphyseal line leaned forward,epiphyseal line 1 ～ 4 mm subprime can-cellous bone trabecular were messy in group A. The epiphyseal line of Group B and group C was clearly visible and still kept normal structure form,but bone trabecular number sparse,structure arrangement in group B were poor than those of group C. Percentage of trabecular bone area, width,number of group C were higher than those of group A and group B,the differences were statistically significant (P0.05);Bone trabecular separation degrees in group C was lower than that of group A and group B,the differences were statistically significant (P0.05). Conclusion Bisphosphonates combined meth- otrexate inhibits the CIA rats bone loss around the joint inflammation,joint and the joint erosion,double phosphate alone had no effect.