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背景:关节腔内激素注射治疗关节炎能迅速缓解关节疼痛,但可发生进行性软骨损害。加用具有生长因子样作用的胰岛素,是否可产生对关节软骨细胞的保护作用?目的:观察胰岛素和氢化可的松联合作用对软骨细胞生长的影响。设计:分组对比观察,1种药物单独作用采用单因素方差分析,2种药物复合作用采用多因素实验设计资料方差分析的析因分析。单位:广州市创伤外科研究所。材料:4～6周龄的新西兰大白兔膝关节软骨。方法:实验于2000-02/2001-05在广州市创伤外科研究所完成。将软骨碎片分别用透明质酸酶,胰酶及Ⅱ型胶原酶消化,获得软骨单细胞悬液,予以不同作用及其不同剂量的药物干预。根据应用干预药物剂量的不同将其分为4组及相应亚组。对照组(不加氢化可的松和胰岛素),胰岛素(0.035,0.35,3.5,35mg/L)组,氢化可的松(1,5,10,50,100mg/L)组,胰岛素(0.35mg/L)+氢化可的松(50mg/L)组,应用四氮甲基唑蓝比色分析法观察其对软骨细胞增殖的影响。主要观察指标:①胰岛素对软骨细胞增殖的影响。②氢化可的松对软骨细胞增殖的影响。③氢化可的松与胰岛素联合使用对软骨细胞增殖的影响。结果:①胰岛素可促进软骨细胞增殖:单独使用0.035mg/L即可发挥效应,当浓度增至0.35mg/L时,其促进作用达到最大值。②氢化可的松对软骨细胞增殖的抑制作用:单独使用10mg/L时即可发挥效应,随着浓度增大抑制作用显著,当浓度增大至100mg/L,软骨细胞几乎全部死亡。③0.35mg/L胰岛素与50mg/L氢化可的松联合使用:存在着负协同作用(F=164.9,P<0.01)。结论:低浓度胰岛素对软骨细胞的增殖有促进作用。但氢化可的松对软骨细胞的增殖有抑制作用。二者联合使用时,氢化可的松可拮抗胰岛素的作用。
BACKGROUND: Intra-articular injection of hormone for the treatment of arthritis can quickly relieve joint pain, but progressive cartilage damage can occur. Addition of insulin with growth factor-like effect can produce the protective effect on articular chondrocytes? Aim: To observe the effect of insulin and hydrocortisone on chondrocyte growth. Design: group comparison observation, one kind of drug alone use single factor analysis of variance, two kinds of drug compound effect using multi-factor analysis of design analysis of variance factorial analysis. Unit: Guangzhou Institute of Traumatic Surgery. MATERIALS: New Zealand white rabbits knee cartilage from 4 to 6 weeks old. Methods: The experiment was performed at Guangzhou Institute of Trauma Surgery from February 2000 to May 2001. Cartilage fragments were treated with hyaluronidase, trypsin and type Ⅱ collagenase digestion to obtain single cartilage suspension, to be different effects and different doses of drug intervention. Divided into four groups and corresponding subgroups according to the dose of the intervention drug. The control group (no hydrocortisone and insulin), insulin (0.035,0.35,3.5,35mg / L) group, hydrocortisone (1,5,10,50,100mg / L) group, insulin / L) + hydrocortisone (50mg / L) group, the application of azidiazole blue colorimetric assay of chondrocyte proliferation. MAIN OUTCOME MEASURES: ① the impact of insulin on chondrocyte proliferation. ② hydrocortisone on chondrocyte proliferation. ③ hydrocortisone and insulin combination of chondrocyte proliferation. Results: Insulin can promote the proliferation of chondrocytes: 0.035mg / L alone can play an effect, when the concentration increased to 0.35mg / L, the maximum effect of its promotion. ② hydrocortisone on chondrocyte proliferation inhibition: 10mg / L alone can play an effect, with a significant inhibitory effect of increasing concentration, when the concentration increased to 100mg / L, almost all of chondrocytes died. ③ 0.35mg / L insulin and 50mg / L hydrocortisone combination: there is a negative synergistic effect (F = 164.9, P <0.01). Conclusion: Low concentration of insulin can promote the proliferation of chondrocytes. But hydrocortisone can inhibit the proliferation of chondrocytes. When used in combination, hydrocortisone antagonizes the action of insulin.