碘乙酸钠在鼠类骨关节炎造模的方法和作用探索

doi:10.3877/cma.j.issn.1674-134X.2023.04.011

骨关节炎(OA)是一类多发于中老年人的退行性关节疾病，随着中国社会老龄化，该病的患病率逐年上升，且该病的发病机制复杂不明。目前在现有的保守治疗方法中，尚未发现针对发病原因和疼痛机制的有效疗法，并且其终末期的疗法常为关节置换，为了减轻患者因骨关节炎产生的疼痛和相关的治疗花费负担，构建骨关节炎相似表型的动物模型是研究其机制和各种新式保守治疗方法的重要基础之一。目前骨关节炎模型使用的动物种类繁多，方法也是各式各样，相关技术在不断更新和进步，但各种动物种类及造模方法都有其优缺点，为了节省研究的时间和经济成本，其中鼠类关节腔内注射碘乙酸钠导致的骨关节炎动物模型有其优势。由于骨关节炎较常发生在膝和髋两个部位，故本文通过回顾相关文献，对碘乙酸钠在膝和髋关节炎的造模方法和作用进行归纳整理和分析总结，望对骨关节炎的相关研究和临床转化有所帮助。

关键词: 骨关节炎, 碘乙酸, 鼠科, 模型，动物

Osteoarthritis (OA) is a kind of degenerative joint disease mainly affecting middle-aged and elderly people. With the aging of Chinese society, the prevalence rate of this disease is increasing year by year, and the pathogenesis of this disease is complex and unclear. Currently, no effective treatment has been found for the pathogenesis and pain mechanism among the existing conservative treatment methods, and joint replacement is often the end-stage treatment. In order to reduce the pain caused by OA in patients and the related treatment cost burden, the establishment of animal models with similar phenotypes of osteoarthritis is one of the important bases for the study of its mechanism and various new conservative treatment methods. At present, various animal types and methods are used in OA models, and relevant technologies are constantly updated and advanced. However, various animal types and modeling methods have their advantages and disadvantages. In order to save research time and economic cost, animal models of OA caused by the injection of sodium iodoacetate into the joint cavity of mice have their advantages. As OA often occurs in knee and hip, this paper, by reviewing relevant literature, summarized, sorted out, analyzed and summed up the modeling methods and effects of sodium iodoacetate in knee and hip arthritis, hoping to contribute to related research and clinical transformation of osteoarthritis.

Key words: Osteoarthritis, Iodoacetic Acid, Rats, Experimental animal models

表1 OARSI评分表

Table 1 OARSI Scale

级别	程度	组织表现
0级	表面光滑完整	未观察到软骨增大变形和软骨细胞增殖变化
1级	表面完好	可以表现出表层的纤维化，中区和深区不受影响
2级	表面不连续	局部纤维化通过表层区延伸到表层区－中层区部分
3级	垂直裂缝延伸至中部	基质纤维化垂直向下延伸到中区
4级	侵蚀	软骨基质的丧失，最早阶段可能只是表层软骨的脱层
5级	剥蚀	未矿化的透明软骨被完全侵蚀，修复性纤维软骨占据表面的间隙
6级	变形	微裂缝、修复和骨重塑的过程改变了关节面的轮廓

表1 OARSI评分表

Table 1 OARSI Scale

级别	程度	组织表现
0级	表面光滑完整	未观察到软骨增大变形和软骨细胞增殖变化
1级	表面完好	可以表现出表层的纤维化，中区和深区不受影响
2级	表面不连续	局部纤维化通过表层区延伸到表层区－中层区部分
3级	垂直裂缝延伸至中部	基质纤维化垂直向下延伸到中区
4级	侵蚀	软骨基质的丧失，最早阶段可能只是表层软骨的脱层
5级	剥蚀	未矿化的透明软骨被完全侵蚀，修复性纤维软骨占据表面的间隙
6级	变形	微裂缝、修复和骨重塑的过程改变了关节面的轮廓

表2 KL等级评分表

Table 2 KL Grade Scale

级别	程度	X线的表现
0级	无	无骨关节炎的放射影像学特征
1级	可疑	可疑的关节间隙变窄和可能的骨赘
2级	轻度	存在明确的骨赘和可能的关节间隙变窄
3级	中度	多发性骨赘、明确的关节间隙变窄、硬化、可能的骨畸形
4级	严重	大的骨赘、明显的关节间隙变窄、严重的硬化和明确的骨畸形

表2 KL等级评分表

Table 2 KL Grade Scale

级别	程度	X线的表现
0级	无	无骨关节炎的放射影像学特征
1级	可疑	可疑的关节间隙变窄和可能的骨赘
2级	轻度	存在明确的骨赘和可能的关节间隙变窄
3级	中度	多发性骨赘、明确的关节间隙变窄、硬化、可能的骨畸形
4级	严重	大的骨赘、明显的关节间隙变窄、严重的硬化和明确的骨畸形

图1 手术切开给药解剖图，绿色虚线为髋关节间隙^[21]

Figure 1 Anatomy of surgical incision for drug administration, green dotted line is the hip joint space

图2 影像引导下穿刺给药示意图

Figure 2 Schematic diagram of image-guided puncture drug delivery

图3 膝关节体表标志注射示意图

Figure 3 Schematic diagram of the knee joint body marking for injection

表3 髋关节注射方法对比

Table 3 Comparison of hip injection methods

注射方法	优点	缺点
手术切开给药	直视给药下相对准确	创伤大，后期感染风险高
超声引导下穿刺给药	无辐射、创伤小、精准度高、操作时间短	需要操作经验，药物进入关节腔需验证
影像引导下穿刺给药	创伤小，精准度高	有辐射、无法观察神经血管情况

表3 髋关节注射方法对比

Table 3 Comparison of hip injection methods

注射方法	优点	缺点
手术切开给药	直视给药下相对准确	创伤大，后期感染风险高
超声引导下穿刺给药	无辐射、创伤小、精准度高、操作时间短	需要操作经验，药物进入关节腔需验证
影像引导下穿刺给药	创伤小，精准度高	有辐射、无法观察神经血管情况

表4 膝关节注射方式对比

Table 4 Comparison of knee injection modalities

方法	优点	缺点
体表标志穿刺注射	步骤简单，操作方便	需有经验骨科医师操作，易损伤周围血管神经
超声引导下注射	精准度和成功率相对较高，不易损伤血管神经	需要相应设备以及相关操作经验

表4 膝关节注射方式对比

Table 4 Comparison of knee injection modalities

方法	优点	缺点
体表标志穿刺注射	步骤简单，操作方便	需有经验骨科医师操作，易损伤周围血管神经
超声引导下注射	精准度和成功率相对较高，不易损伤血管神经	需要相应设备以及相关操作经验

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Exploration of methodology and role of sodium iodoacetate in modeling of rat osteoarthritis

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Exploration of methodology and role of sodium iodoacetate in modeling of rat osteoarthritis