脂多糖对人工关节磨屑诱导的骨溶解的影响

　　【摘要】 目的 探讨脂多糖(LPS) 促进人工关节松动的可能性。方法 采集30例人体外周血,分离单核细胞(MOs)，分组培养。实验分4组(n=30)：A组(对照组)仅加入MOs;B组加入MOs+LPS(100 μg/L)，C组加入MOs+超高分子聚乙烯微粒(UHMWPE);D组加入MOs+UHMWPE+LPS(100 μg/L)。培养48 h后,放免法测定上清中肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)的含量。结果 D组TNF-α和IL-6水平分别明显高于A、B、C组(P<0.05);B组与C组之间TNF-α、IL-6水平差异无统计学意义(P>0. 05)。结论 LPS 能有效地刺激MOs分泌TNF-α、IL-6，效果与UHMWPE相似,且具有促进UHMWPE刺激TNF-α、IL-6分泌的作用，增强了UHMWPE的溶骨效应。

　　【关键词】 脂多糖;人工关节;磨屑;假体失败;骨溶解

　　Effect of LPS on the osteolysis induced by wear debris in artificial joints

　　DUAN Gang, ZHU Ziqiang, CHEN Hongliang, GE Bing

　　1.Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221006, China;

　　2.Department of Orthopedics, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu 221002

　　Abstract: Objective To explore the possibility of lipopolysaccharide (LPS) contributing to aseptic loosening of orthopedic implants. Methods 30 samples of peripheral blood were obtained from healthy human donors. Monocytes (MOs) were isolated and assigned to 4 groups (n=30 each) for culture. Group A was treated with MOs alone; group B with MOs+LPS (100 μg/L); group C with MOs+ultrahigh molecular weight polylethylene (UHMWPE) debris; group D with MOs+UHMWPE+LPS (100 μg/L). The cells were co-cultured for 48 h and the supernatant was tested for TNF-α and IL-6 content with radioimmunoassay. Results The levels of TNF-α and IL-6 were much higher in group D than in the other 3 groups. There was no significant difference in TNF-α and IL-6 levels between group B and group C (P>0.05). Conclusion LPS effectively stimulates MOs to secrete TNF-α and IL-6. LPS is not only similar to UHMWPE in action, but also promotes UHMWPE to stimulate the secretion of TNF-α and IL-6, therefore enhancing the osteolytic effect of UHMWPE.

　　Key words: lipopolysaccharide; artificial joint; wear debris; prosthesis failure; osteolysis

　　人工关节的无菌性松动是影响关节置换术后远期疗效的主要因素[1]。在无菌性松

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