The Study Of Aspirin And Atorvastatin For The Prevention Of Steroid Induced Osteonecrosis Of The Femoral Head

Objective:To study the effects of aspirin combination treatment with atorvastatin on prevention of early steroid-induced osteonecrosis of the femoral head in rats and to explore the feasibility and mechanism of combination therapy on preventing ischemic necrosis of the femoral head?Methods:48 healthy rats were randomly divided into 4 groups with 12 rats in each group.Group A as model group,model group(The experimental group was injected intraperitoneal injection two times lipopolysaccharide(20 g /kg),24 h,24 h after the intramuscular injection of high-dose methylprednisolone(40 mg /kg)three conductive injections,Each interval of 24 hour to produce ONFH model;B group for the intervention group,modeling method with model group,intraperitoneal injection of hormone deily anticoagulant aspirin 12.5 mg/kg intragestrically.C group for the intervention group.After intraperitoneal injection of hormone,the lipid lowering drug atrobastatin 1 mg / kg(was administered intragastrically)kg gavage.Group D was treated with the same mathod as the model group.After intraperitoneal injection of hormones,the patients were given aspirin12.5 mg/kg andanticoagulant daily and atrovastatin.1 mg / kg lipid-lowering drug for 2weeks.6 weeks after the injection,blood lipid and blood coagulation level were measured,histopathological examination was parformed by HE staining to observe the pathological changes of the femoral head and skull tissue structure.The image of empty skull dimples,bone lacuna area and trabecular area Quantitative analysis.Micro CT was used to study the changes of trabecular bone microstructure.RNA was extracted from bone tissue of standard femoral head,and the expression level of HIF-1? m RNA and SREBP-2 m RNA was detected by Realtime-PCR technology.Results:Determination of blood lipids and coagulation indexes:The levels of prothrombin time(PT),activated partial thromboplastin time(APTT)in the model group were significantly lower than those in the untreated group(p <0.05),the levels of total cholesterol(TC)Triglyceride(TG)The concentration was higher than that in the treatment group.(P < 0.05)?Observation of Group A with HE stainiing The empty lacunae rate is high,the number of fat cells and large volume.Group B(Anticoagulant)reduce the amount of fat cells and empty lacunae rate is very low.bone lacuna bone cells were generally normal,fat cells are rare.Group C(Atorvastatin calcium)fat cells were significantly reduced,the empty lacunae rate is low.Group D Bone lacuna bone cells were generally normal,fat cells are rare.The rate of empty bone lacuna and the area of bone lacuna in the model group were significantly higher than those in the treatment group by image analyzer quantitative analysis.(P < 0.05)compared with the treatment group the area of trabeculae was significantly decreased(P < 0.05)indicating that the model replication was successful,the treatment group had a significant effect.Micro-CT showed that trabecular bone was changed in different groups.The BMD,BV/TV,BS/BV and Tb.Th in the treatment group were significantly higher than those in the model group,and Tb.Sp was significantly decreased.(P < 0.05)?The BMD,BV/TV,BS/BV,Tb.Th in group D were higher than those in group B and C.(P < 0.05)There was nosignificantly difference between the two groups(P > 0.05)?BMD,BV/TV,BS/BV and Tb.Th were significantly decreased and Tb.Sp was significantly increased in the model group.(P < 0.05)?The expression model group of HIF-1 alpha and Srebp-1 increased(P < 0.05).Conclusion: Hyperglycaemia and anticoagulant drugs can prevent the use of large doses of hormone induced necrosis of the femoral head,and the effect of combined use is better than that of a single drug.