【作者】 张琦；

【导师】 卜海富；

【作者基本信息】 安徽医科大学 ， 外科学， 2009， 硕士

【摘要】 背景骨折的愈合是个非常复杂的过程,其影响因素也是多方面的,包括骨折局部的血运、年龄和健康状况、医源性因素等。近年来各种生长因子和内分泌因素对骨折愈合影响已成为热门课题。本研究主要就重组人甲状旁腺素1-34片段对小范围骨缺损的促愈合作用进行实验研究,以期发现其对骨折愈合的影响。目的研究间歇性低剂量应用重组人甲状旁腺素(rhPTH1-34)对兔胫骨小范围骨缺损的治疗作用。方法50只新西兰大白兔于右侧胫骨中段造成3mm缺损,术后予石膏外固定,随机分成A,B两组。术后第二天A组开始按30μg/(kg·d)行腹部皮下注射,每周3次,共4周.B组按同样方法注射等量生理盐水。术后1、2、3、4周每组随机抽取兔4只处死取材,行X线射片,骨密度(BMD)、骨矿物含量(BMC)测试,BMP-2(骨形态发生蛋白-2)免疫组化染色并观察并且第4周行HE切片染色观察。结果A组的骨痂面积、成骨细胞含量同期均高于B组。治疗后2组间和组内比较差异均有显著性,2组BMD和BMC在术后随时间延长增加,2、3、4周时A组BMD和BMC高于B组(P<0.05,P<0.01),A组在2、3、4周BMP-2的表达均高于对照组,二者差异有显著性(P﹤0.01).结论间歇性低剂量应用rhPTH1-34能够促进成骨细胞分化,加速骨矿物沉积,同时诱导BMP-2表达从而加速骨折的愈合.更多还原

【Abstract】 Objective: To study the effect of intermittent low-dose administration of rhPTH(1-34) on fracture healing.Methods: A 3 mm gap was performed in right mid-tibials of 50 New Zealand white rabbits.The osteotomy site was stabilized with long plaster cast external fixation.The rabbits were divided randomly into two groups such as A and B group.On the postoperative day,the A group were administrated with rhPTH(1-34) by hypodermic injection,while the B group with NS,3 times a week for 4 weeks.Fracture healing was assessed with X-ray,BMD、BMC test,BMP-2 immunohistochemistry dying.At 4th week of postoperation,histologic analysis was tested with callus and quantity of osteoblast.Results: Callus,the quantity of osteoblast in the A group were more than the B group.There are difference between two groups and intergroup.BMD and BMC at the 2 groups increased along with times,it was much more in the A group than that in the B group at 2、3、4 week(p<0.05,p<0.01).The expression of BMP-2 in the A group higher than it in the B group at 2、3、4 weeks,showing a significant difference(p<0.01) Conclusion: Intermittent low-dose administration of rhPTH(1-34) can obviously promote the fracture healing,accelerat the differentiation of osteoblasts、the mineralization of bone and expression of BMP-2.更多还原