射频能量对关节软骨细胞活性的实验研究

肖建华

[摘要]目的 研究射频能量对关节软骨细胞活性的影响效果，进而验证该方法临床可行性。方法 选取10对牛关节软骨中的5对作为射频能量的实验对象，每对两侧分为4个单元格，其中3个单元格作为研究组，分别对应SCULPTOR单极射频头、SAPHYRE双极射频头、TAC-C Ⅱ软骨温控头，处理的时间设定为1 min，剩余1个单元格作为对照组，不做射频处理。取剩下的5对牛关节软骨作为处理时间的实验对象，分别使用SAPHYRE双极射频头以5、10、20、30 s进行射频处理，其中4组作为研究组，剩余1组不作处理，作为对照组。观察研究组与对照组苏木精-伊红染色（简称HE染色）、荧光染色和GAG释出率测定数值的差异，分析其细胞活性和组织受损情况的差异。结果 SCULPTOR单极射频头组、SAPHYRE双极射频头组、TAC-C Ⅱ软骨温控头组的细胞HE染色、荧光染色的空泡率和死亡率均显著高于对照组，差异有统计学意义（P<0.05）；第1天，SCULPTOR单极射频头组、SAPHYRE双极射频头组、TAC-C Ⅱ软骨温控头组的软组织GAG释出率显著低于对照组，第2、3天，SAPHYRE双极射频头组、TAC-C Ⅱ软骨温控头组的软组织GAG释出率显著低于对照组，差异有统计学意义（P<0.05）；采用5、10、20、30 s时间处理组的细胞HE染色、荧光染色的空泡率和死亡率均显著高于对照组，差异有统计学意义（P<0.05）；第1、2、3天，采用5、10、20、30 s时间处理组的软组织GAG释出率均显著低于对照组，差异有统计学意义（P<0.05）。结论 射频能量和处理时间的增加都会导致关节软组织受损，且与增加数值成正相关，因此需要适当降低射频能量和處理时间，避免治疗时对患者形成组织损伤。

[关键词]射频能量；关节软骨；细胞活性；苏木精-伊红染色；GAG释出率

[中图分类号] R681.53 [文献标识码] A [文章编号] 1674-4721（2018）7（c）-0120-04

[Abstract] Objective To study the effect of radiofrequency energy on the cell activity of articular cartilage， so as to verify the clinical feasibility of this technique. Methods A total of 10 pairs of bovine articular cartilage were selected，of which five pairs were used as radiofrequency energy subjects. The sides of each pair were divided into four table cells， of which three ones were for research， respectively corresponding to SCULPTOR monopolar radiofrequency head， SAPHYRE bipolar radiofrequency head， and TAC-C Ⅱ cartilage temperature-controlled head for 1 min. The remaining one was as a control without radiofrequency. The rest five pairs were selected as experimental subjects in different processing time （5， 10， 20， and 30 second）， of which four pairs disposed with SAPHYRE bipolar radiofrequency head were selected as the research group and the last one without disposal was selected as the control group. The above-mentioned research groups and control groups were compared in order to observe the differences of hematoxylin-eosin staining （HE staining）， fluorescence staining， and GAG release rate， and the differences of cell activity and tissue damage were analyzed. Results The vacuolization rate and mortality rate of the HE staining and fluorescence staining in the SCULPTOR monopolar radiofrequency head group， the SAPHYRE bipolar radiofrequency head group， and the TAC-C Ⅱ cartilage temperature-controlled head group were significantly higher than those of the control group， and the differences were statistically significant （P<0.05）. On the first day， the soft tissue GAG release rate in the SCULPTOR monopolar radiofrequency head group， the SAPHYRE bipolar radiofrequency head group， and the TAC-C Ⅱ cartilage temperature-controlled head group was significantly lower than that in the control group； on the second and third days， the GAG release rate of soft tissue of the SAPHYRE bipolar radiofrequency head group and the TAC-C Ⅱ cartilage temperature-controlled head group was significantly lower than that of the control group， and the differences were statistically significant （P<0.05）. The vacuolization rate and the mortality rate of the HE staining and fluorescence staining in the 5， 10， 20， and 30 s treatment groups were significantly higher than those in the control group， and the differences were statistically significant （P<0.05）. On the first， second， and third days， the GAG release rate of soft tissue in the 5， 10， 20， and 30 s treatment groups were significantly lower than that in the control group， and the differences were statistically significant （P<0.05）. Conclusion The increase of radiofrequency energy and processing time both will lead to the damage of the joint soft tissue in a positive correlation. Therefore， it is necessary to appropriately reduce the radiofrequency energy and processing time in order to avoid tissue damage in patients during treatment.