LU Ziru, XIE Lin, XIANG Pingping, LIANG Yu, YAN Liang, LIANG Aijun. Effect of simvastatin in treatment of alcoholic osteonecrosis of femoral head and preliminary exploration of mechanism[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 96-100. DOI: 10.7619/jcmp.20201978
Citation: LU Ziru, XIE Lin, XIANG Pingping, LIANG Yu, YAN Liang, LIANG Aijun. Effect of simvastatin in treatment of alcoholic osteonecrosis of femoral head and preliminary exploration of mechanism[J]. Journal of Clinical Medicine in Practice, 2021, 25(8): 96-100. DOI: 10.7619/jcmp.20201978

Effect of simvastatin in treatment of alcoholic osteonecrosis of femoral head and preliminary exploration of mechanism

More Information
  • Received Date: December 30, 2020
  • Available Online: March 28, 2021
  • Published Date: April 27, 2021
  •   Objective  To observe the effect of simvastatin combined with alendronate sodium in treating alcohol-induced avascular necrosis of femoral head (AIANFH) and its impact on toll-like receptor 4 (TLR4)/nuclear factor κB (NF-κB) pathway.
      Methods  A total of 90 patients with AIANFH were selected and divided into observation group and control group, with 45 cases in each group. The control group was treated with alendronate sodium orally, and the observation group was addtionally given simvastatin. The course of treatment was 3 months. The excellent rate of hip joints and incidence of adverse reactions after treatment of two groups were compared, and serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), adiponectin, osteocalcin and the mRNA expressions of TLR4 and NF-κB p65 in peripheralblood mononuclear cells (PBMC) were compared between the two groups before and after treatment.
      Results  The excellent rate of hip joints in observation group was higher than that in the control group (91.11% versus 75.56%, P < 0.05). After treatment, serum TNF-α, IL-1β, and IL-6 levels of two groups were significantly lower than treatment before, and serum adiponectin and osteocalcin were increased (P < 0.05). After treatment, expressions of TLR4 mRNA and NF-κB p65 mRNA of PBMC in two groups were decreased, and the were lower in the observation group than those in the control group (P < 0.05). The total incidence of adverse reactions in the observation group and the control group were 24.44% and 15.56%, but no differences were found(P>0.05).
      Conclusion  Simvastatin combined with alendronate sodium can inhibit the TLR4/NF-κB signaling pathway, inhibit inflammation, and up-regulate the levels of adiponectin and osteocalcin, and it has higher safety.
  • [1]
    陈志伟, 王振涛, 李泰贤, 等. 酒精相关性股骨头坏死的发病特征分析[J]. 中医正骨, 2017, 29(12): 23-25, 30. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201712005.htm
    [2]
    都帅刚, 郭中华, 孔倩倩, 等. 肾气汤加减治疗早中期非创伤性股骨头坏死的临床观察[J]. 中成药, 2018, 40(1): 55-60. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYA201801010.htm
    [3]
    乔登朝, 李志强, 王少华. 活络骨康丸联合辛伐他汀治疗非创伤性股骨头坏死临床观察[J]. 风湿病与关节炎, 2016, 5(10): 20-22. https://www.cnki.com.cn/Article/CJFDTOTAL-FSBG201610006.htm
    [4]
    KOSUKEGAWA I, OKAZAKI S, YAMAMOTO M, et al. The proton pump inhibitor, lansoprazole, prevents the development of non-traumatic osteonecrosis of the femoral head: an experimental and prospective clinical trial[J]. Eur J Orthop Surg Traumatol, 2020, 30(4): 713-721. doi: 10.1007/s00590-020-02622-5
    [5]
    中华医学会骨科分会显微修复学组, 中国修复重建外科专业委员会骨缺损及骨坏死学组. 成人股骨头坏死诊疗标准专家共识(2012年版)[J]. 中华骨科杂志, 2012, 32(6): 606-610. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJW201202020.htm
    [6]
    HARRIS W H. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation[J]. J Bone Joint Surg Am, 1969, 51(4): 737-755. doi: 10.2106/00004623-196951040-00012
    [7]
    陶振宇, 张月雷, 陈华, 等. 细胞自噬在酒精性股骨头坏死中的作用及相关机制研究[J]. 中医正骨, 2018, 30(10): 4-11. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZG201810003.htm
    [8]
    王小龙, 韩超前, 赵晓娜, 等. 普伐他汀能否降低早期兔激素诱导性股骨头坏死发生的风险[J]. 中国组织工程研究, 2018, 22(32): 5097-5103. doi: 10.3969/j.issn.2095-4344.0548
    [9]
    汪瑜, 熊德建, 罗梅懿, 等. 葛根素联合阿托伐他汀用药对激素性股骨头缺血性坏死Hedgehog信号通路的影响[J]. 四川医学, 2019, 40(6): 552-557. https://www.cnki.com.cn/Article/CJFDTOTAL-SCYX201906003.htm
    [10]
    陈俊宇, 王建忠. 成骨细胞、破骨细胞与酒精性股骨头坏死的关联性: 预防与靶向治疗的新思路[J]. 中国组织工程研究, 2016, 20(46): 6963-6969. https://www.cnki.com.cn/Article/CJFDTOTAL-XDKF201646019.htm
    [11]
    谢程欣, 王维, 余城墙, 等. 酒精性股骨头坏死动物模型的研究进展[J]. 中国比较医学杂志, 2020, 30(7): 139-144. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGDX202007020.htm
    [12]
    董威, 王健, 贾国兴, 等. 抗凝联合他汀类降脂药治疗激素性股骨头坏死大鼠模型疗效及机制研究[J]. 东南大学学报: 医学版, 2019, 38(1): 131-135. https://www.cnki.com.cn/Article/CJFDTOTAL-NJTD201901027.htm
    [13]
    赵红星, 黄媛霞, 徐海斌, 等. 他汀类药物治疗激素性股骨头坏死的效果及机制研究[J]. 西北药学杂志, 2017, 32(3): 359-363. https://www.cnki.com.cn/Article/CJFDTOTAL-XBYZ201703031.htm
    [14]
    丁文波, 杨璐, 宫兆奇, 等. 辅酶Q10辅助辛伐他汀治疗激素相关性兔股骨头坏死的疗效和可能机制[J]. 中国老年学杂志, 2018, 38(5): 1215-1217. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ201805079.htm
    [15]
    王涛, 张育民, 王军伟, 等. 辛伐他汀联合抗凝药物治疗老年激素性股骨头坏死临床效果及安全性分析[J]. 解放军医药杂志, 2017, 29(7): 54-57, 61. https://www.cnki.com.cn/Article/CJFDTOTAL-HBGF201707015.htm
    [16]
    何宁, 曾云, 王志勇, 等. 11β-HSD1抑制剂对大鼠股骨头坏死微环境及骨重建影响的实验研究[J]. 实用药物与临床, 2018, 21(4): 383-386. https://www.cnki.com.cn/Article/CJFDTOTAL-LYLC201804006.htm
    [17]
    吴兴净, 陶周善, 郭雄, 等. TLR4/NF-κB在酒精性股骨头坏死骨组织中的表达及意义[J]. 西安交通大学学报: 医学版, 2019, 40(3): 445-450. https://www.cnki.com.cn/Article/CJFDTOTAL-XAYX201903021.htm
    [18]
    农焦, 曾平. TLR4/NF-κB信号转导通路在激素性股骨头坏死防治研究中的应用[J]. 中华中医药学刊, 2019, 37(7): 1689-1693. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201907037.htm
    [19]
    ADAPALA N S, YAMAGUCHI R, PHIPPS M, et al. Necrotic bone stimulates proinflammatory responses in macrophages through the activation of toll-like receptor 4[J]. Am J Pathol, 2016, 186(11): 2987-2999. http://www.sciencedirect.com/science/article/pii/S0002944016303005
    [20]
    MITCHELL S, VARGAS J, HOFFMANN A. Signaling via the NF-κB system[J]. Wiley Interdiscip Rev Syst Biol Med, 2016, 8(3): 227-241. http://escholarship.org/uc/item/0g97w76k
  • Cited by

    Periodical cited type(5)

    1. 郭志华,王俊发,王佳. 骨蚀再造丸联合辛伐他汀对激素性股骨头坏死患者髋关节功能、血液流变学和骨代谢的影响. 中国中医药科技. 2024(02): 240-242 .
    2. 陈柏豪,何琪,杨均政,潘兆丰,肖嘉聪,黎淼,黎少聪,曾嘉旭,王海彬,郑稼,张濛. Piezo1蛋白在股骨头坏死发病机制中的意义. 中国组织工程研究. 2023(27): 4414-4420 .
    3. 徐珮琼,郑治国,伍军. 正畸牙移动中脂联素调控PI3K/AKt信号通路对牙周组织改建的影响. 中国临床解剖学杂志. 2023(05): 583-587 .
    4. 陈伟,卿黎明,吴攀峰,唐举玉. 酒精性股骨头坏死发病机制和基因学研究进展. 中国修复重建外科杂志. 2022(11): 1420-1427 .
    5. 钱利海,梁清宇. 成人早中期股骨头坏死保髋治疗的最新研究进展. 实用骨科杂志. 2022(11): 997-1001 .

    Other cited types(3)

Catalog

    Article views (432) PDF downloads (22) Cited by(8)

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return