Uno K, Kawai K, Hirohata K, Ito H
Department of Orthopaedic Surgery, Kobe University School of Medicine.
Ryumachi. 1991 Jun;31(3):282-9.
High dose corticosteroid therapy constitutes one of major causes of osteonecrosis of the femoral head. To examine the early changes of the femoral head induced by corticosteroid therapy, 20 femoral heads were obtained at autopsy and the other 19 femoral heads without having been on steroid were served as controls. Histological examination from steroid treated group revealed that in areas of subchondral bone there were observed necrotic changes of osteocytes. The nucleus was so pressed to one side of the cell as to assume crescent like aspect. When stained with Sudan IV, fat positive materials were found in the osteocyte lacunae. Electron micrographic examination revealed intracellular fat as low electron dense droplets in these degenerative osteocytes. Examination of bone marrow showed an increase of the number of fat cells in steroid treated group. These changes in man may represent some failure in lipid metabolism, although it is unknown whether these events may produce osteonecrosis of the femoral heads.
大剂量皮质类固醇疗法是股骨头坏死的主要原因之一。为了研究皮质类固醇疗法引起的股骨头早期变化，尸检获取了20个股骨头，另外19个未使用过类固醇的股骨头作为对照。对接受类固醇治疗组的组织学检查显示，在软骨下骨区域观察到骨细胞坏死变化。细胞核被挤压到细胞的一侧，呈月牙状。用苏丹IV染色时，在骨细胞陷窝中发现了脂肪阳性物质。电子显微镜检查显示，在这些变性骨细胞中，细胞内脂肪呈低电子密度小滴。对骨髓的检查显示，接受类固醇治疗组的脂肪细胞数量增加。尽管尚不清楚这些情况是否会导致股骨头坏死，但人类的这些变化可能代表脂质代谢出现了某些故障。
