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目的:探讨人脐带间充质干细胞(hUC-MSCs)对大鼠早期激素性股骨头坏死(GC-ONFH)防治作用及其机制。方法:将48只SD大鼠完全随机法分为4组：对照组、模型组、低剂量治疗组、高剂量治疗组。使用注射用甲泼尼龙琥珀酸钠建立GC-ONFH的模型，并给予不同剂量的hUC-MSCs干预。6周后分离股骨头组织，利用苏木精-伊红(HE)染色、原位缺口末端标记法(TUNEL)染色、微型CT(Micro-CT)、蛋白质印迹法(Western blot)和定量聚合酶链反应(qPCR)评价股骨头坏死、细胞凋亡、骨密度及凋亡相关蛋白mRNA表达水平。采用n t检验和完全随机设计的方差分析。n 结果:对照组、模型组、高剂量治疗组和低剂量治疗组股骨头坏死发生率分别为0(0/12)、83%(10/12)、17%(2/12)、50%(6/12)，空骨陷窝率和细胞凋亡率分别为(2.301±1.238)%、(26.138±2.742)%、(10.229±2.658)%和(13.518±2.241)%，治疗组中空骨陷窝率和细胞凋亡率显著低于模型组(n F＝13.45，n P<0.05)，差异有统计学意义。Micro-CT结果显示对照组、模型组、高剂量治疗组和低剂量治疗组骨体积分数分别为(0.618±0.147)%、(0.250±0.130)%、(0.563±0.127)%、(0.358±0.057)%，骨小梁厚度分别为(0.448±0.086)、(0.218±0.082)、(0.418±0.059)、(0.292±0.051) mm，骨小梁间隙分别为(0.042±0.010)、(0.016±0.008)、(0.036±0.004)、(0.023±0.004) mm，骨小梁数量分别为(4.233±1.137)、(1.950±0.650)、(3.633±0.717)、(2.333±0.457)/mm，治疗组上述指标显著高于模型组(n F＝11.75、13.02、14.22、10.79，n P<0.05)，差异有统计学意义。Western blot检测对照组、模型组、高剂量治疗组和低剂量治疗组B细胞淋巴瘤/白血病-2相关X蛋白(bcl-2 )蛋白表达分别为(1.000±0.039)、(7.508±0.253)、(1.540±0.182)、(3.778±0.160)，bcl-2蛋白表达分别为(1.000±0.053)、(0.202±0.046)、(0.745±0.083)、(0.485±0.065)，半胱氨酰天冬氨酸特异性蛋白酶-3(Caspase-3)蛋白表达分别为(1.000±0.045)、(8.917±0.238)、(1.694±0.189)、(4.250±0.164)，qPCR检测对照组、模型组、高剂量治疗组和低剂量治疗组bax mRNA表达分别为(1.000±0.056)、(4.433±0.192)、(1.933±0.142)、(2.367±0.134)，bcl-2 mRNA表达分别为(1.000±0.037)、(0.227±0.029)、(0.793±0.032)、(0.617±0.036)，Caspase-3 mRNA表达分别为(1.000±0.062)、(4.467±0.393)、(1.800±0.180)、(2.600±0.131)，模型组bcl-2表达显著低于对照组，Caspase-3、bax表达显著高于对照组，经hUC-MSCs干预后情况改善显著(n F＝67.74、54.68、104.40，n P<0.05)，差异有统计学意义。n 结论:hUC-MSCs可能通过调节bax、bcl-2、Caspase-3的表达，抑制糖皮质激素诱导的成骨细胞凋亡，有助于防治大鼠早期GC-ONFH。“,”Objective:To investigate the effect and possible mechanism of human umbilical cord mesenchymal stem cells (hUC-MSCs) preventing rats from glucocorticoid-induced osteonecrosis of femoral head.Methods:A total of 48 sprague dawlaya rat were randomly divided into 4 groups: control group, model group, low dose treatment group and high dose treatment group. Osteonecrosis was induced by methylprednisolone, and the treatment group was treated with different doses of hUC-MSCs. At 6th week, all animals were sacrificed. Hematoxylin and eosin (HE) staining, terminal dexynucleotidyl transferase(TdT)-mediated dUTP nick end labeling (TUNEL) staining, Micro-CT, Western blotting and quantitative real-time polymerase chain reaction (qPCR) were used to evaluate the rate of femoral head necrosis, the apoptosis, bone mineral density and apoptosis-related proteins by the variance analysis and n t test.n Results:The necrosis rate of femoral head in control group, model group, high dose treatment group and low dose treatment group was 0 (0/12), 83% (10/12), 17% (2/12), 50% (6/12), respectively, and the rate of empty bone lacuna and positive cells in the HE staining and Tunel staining of four groups was (2.301±1.238)%, (26.138±2.742)%, (10.229±2.658)% and (13.518±2.241)%, respectively. The empty bone lacuna rate and apoptosis rate in the treatment group were significantly lower than those in the model group, and those in the high dose group were significantly higher than those in the low dose group (n F=13.45, n P<0.05). Micro-CT showed bone volume fraction in control group, model group, high dose treatment group and low dose treatment group was (0.618±0.147)%, (0.250±0.130)%, (0.563±0.127)% and (0.358±0.057)%, trabecular thickness was (0.448±0.086), (0.218±0.082), (0.418±0.059) and (0.292±0.051) mm, trabecular spacing was (0.042±0.010), (0.016±0.008), (0.036±0.004) and (0.023±0.004) mm, trabecular number was (4.233±1.137), (1.950±0.650), (3.633±0.717) and (2.333±0.457)/mm, respectively, and the above indexes in the treatment groups were significantly higher than those in the model group (n F=11.75, 13.02, 14.22, 10.79, n P<0.05). Western blotting showed the expression of bax protein in control group, model group, high dose treatment group and low dose treatment group was (1.000±0.039), (7.508±0.253), (1.540±0.182) and (3.778±0.160), that of bcl-2 protein was (1.000±0.053), (0.202±0.046), (0.745±0.083) and (0.485±0.065), and that of Caspase-3 protein was (1.000±0.045), (8.917±0.238), (1.694±0.189) and (4.250±0.164), respectively. PCR showed the expression of bax mRNA in control group, model group, high dose treatment group and low dose treatment group was (1.000±0.056), (4.433±0.192), (1.933±0.142) and (2.367±0.134), that of bcl-2 mRNA was (1.000±0.037), (0.227±0.029), (0.793±0.032) and (0.617±0.036), and that of Caspase-3 mRNA was (1.000±0.062), (4.467±0.393), (1.800±0.180) and (2.600±0.131), respectively. The expression of bcl-2 in model group decreased significantly as compared with control group, and that of bax and Caspase-3 increased significantly. hUC-MSCs could reverse these changes after treatment (n F=67.74, 54.68, 104.40, n P<0.05).n Conclusion:hUC-MSCs may inhibit apoptosis of osteoblasts by regulating the expression of bcl-2, bax and Caspase-3 to prevent and treat early glucocorticoid-induced osteonecrosis of femoral head in rats.