目的:观察臭氧关节腔注射治疗后,兔膝骨性关节炎模型中滑膜的病理改变及其一氧化氮合酶(nitric oxide synthase,NOS)和转化生长因子β(transforming growth factor-β,TGF-β)的变化,进一步探讨臭氧治疗骨性关节炎的作用.方法:将24只成年新西兰兔随机分为正常组、模型组、假治疗组、臭氧治疗组.造模成功后,臭氧治疗组关节腔注射40 μg/ml臭氧(1 ml)治疗,每周一次,连续两周,假治疗组予以等量空气对照.比较四组膝关节滑膜厚度及病理改变、滑膜组织中NOS和TGF-β阳性细胞的表达水平.结果:1.各组与正常组比较滑膜厚度均显著增高(P＜0.01),假治疗组与模型组无差别,臭氧治疗组较模型组滑膜厚度降低(P＜0.05).2.正常组滑膜上皮细胞呈单层、扁平、立方状分布,未见细胞增生,滑膜组织结构正常；模型组滑膜组织正常结构破坏,细胞重度增生,排列混乱,大量炎性细胞侵润,血管增生充血；假治疗组滑膜炎症无明显改善；臭氧治疗组滑膜组织结构改善,炎症细胞减少.3.各组与正常组比较滑膜中NOS表达增高(P＜0.05),TGF-β表达降低(P＜0.05),假治疗组与模型组无差别,臭氧治疗组较模型组NOS表达降低(P＜0.05),TGF-β表达增高(P＜0.05).结论:关节腔注射40 μg/ml臭氧(1 ml)可以明显减轻滑膜炎症,抑制滑膜中NOS的表达,促进TGF-β的生成,可能是臭氧治疗骨性关节炎的机制之一.%Objective: To observe the effects of ozone on pathological changes, the copression of nitric oxide synthase (NOS) and transformation growth factor β (TGF-β) of the synovium in knee osteoarthritis of rabbits and explore the mechanism of medical ozone on the knee osteoarthritis. Methods: Twenty-four adult rabbits were randomly and evenly divided into four groups: normal group, model group, sham treatment group and ozone treatment group. After the osteoarthritis models were made successfully, ozone treatment group was received intra-articular injection of O3 40 μg/ml (1 ml) once a week, for two weeks. Sham treatment group was received 1 ml air. The pathological changes, NOS and TGF-p of the synovium were compared among four groups. Results: 1. Compared with normal group, synovium thickness was significantly increased in the other three groups (P ＜ 0.01). There was no significant difference between sham treatment and model groups. Compared with model group, synovium thickness was reduced in ozone treatment group (P ＜ 0.05). 2 . In the normal group, synovial epithelial cells were single and flat, cubic shape distribution, cell hyperplasia. In model group, synovial normal structural organization was damaged, without cell hyperplasia and chaos appeared, large inflammatory cells invaded, vascular proliferation and congestion appeared. In sham treatment group, synovial inflammation did not obviously improved. In ozone treatment group, synovial organization structure improved and the inflammatory cells reduced.3. Compared with normal group, NOS expression was increased (P ＜ 0.05) and TGF-β expression were reduced (P ＜ 0.05) in the other groups. There was no significant difference of NOS and NGF-β expression between sham treatment and model groups. Compared with model group, NOS were reduced (P ＜ 0.05) and TGF-p were increased (P ＜ 0.05) in ozone treatment group. Conclusion: Injection of 40 μg/ml ozone (1 ml) can significantly reduce synovial inflammation, reduce NOS expression and increase TGF-p expression in the synovial. These may serve as the mechanism of medical ozone for the treatment of knee osteoarth-ritis.
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