掺锶硫酸钙治疗松质骨骨缺损以及对血液流变学影响的实验研究

发布时间：2018-05-14 09:54

本文选题：硫酸钙 + 锶元素　；参考：《川北医学院》2015年硕士论文

【摘要】：目的:观察掺锶硫酸钙局部植入对兔股骨髁部骨缺损的修复作用,并探讨修复过程中机体血液流变学的改变。方法:将48只新西兰兔股骨髁部进行骨缺损造模后,随机分为掺锶硫酸钙组(研究组)、半水硫酸钙组(对照组)与模型组。研究组在骨缺损局部植入(Sr Cl2的摩尔比例为0.5%)掺锶硫酸钙修复材料;对照组骨缺损区域植入半水硫酸钙修复材料;模型组则缺损部位旷置。术后4、12w进行CT影像学检测,观察骨缺损的修复情况,并进行新骨影像学评分。术后8、12 w处死动物,取股骨下段,对股骨远端的骨缺损区进行压凹实验。术后2、4 w分别利用茜素红S与钙黄绿素进行荧光标记,并于术后8w取标本进行组织形态学观察。术前及术后2、8、12 w耳缘静脉采血,测定生化指标与血液流变学指标。结果:实验动物骨缺损造模后,与手术前比较,血清中的碱性磷酸酶(ALP)均显著性升高(P0.05);术后2 w,研究组的ALP显著高于模型组与对照组(P0.05),其他生化指标包括谷草转氨酶、谷丙转氨酶、尿素氮、肌酐、尿酸未见显著性差异(P0.05)。CT扫描结果显示,术后12 w,研究组的骨缺损局部区域被新生骨组织充满,其密度与正常骨组织几乎一样,对照组12 w时,骨缺损局部仍可见少量植入材料的碎片。术后4 w,研究组的新骨形成的影像学评分高于对照组(P0.05)。术后8 w和12 w,研究组的股骨髁骨缺损区压缩强度均高于对照组(P0.05)。形态学研究结果显示,术后2 w,研究组的骨生成显著高于对照组(P0.01);术后4 w,研究组的骨矿化显著优于对照组(P0.01)。血液流变学研究发现,动物骨缺损造模后,全血血液黏度、血浆黏度与血小板聚集均显著性升高(P0.01);术后8 w,研究组的全血黏度(1/200 s)、血浆粘度与血小板聚集率均显著低于对照组(P0.05)。结论:0.5%掺锶硫酸钙对松质骨骨缺损具有显著的促进修复作用,而且能显著改善由于骨缺损引起的全血黏度、血浆黏度与血小板聚集的异常升高,其效果优于单纯的硫酸钙,是一种较好的骨修复材料。
[Abstract]:Objective: to observe the effect of local implantation of strontium-doped calcium sulfate on the repair of femoral condylar bone defect in rabbits and to explore the changes of hemorheology in the process of repair. Methods: 48 New Zealand rabbits with femoral condylar defects were randomly divided into strontium doped calcium sulfate group (study group), hemihydrate calcium sulfate group (control group) and model group. In the study group, the molar ratio of Sr Cl2 in bone defect was 0.5) the strontium calcium sulfate repair material was implanted in the bone defect area of the control group, and the defect site was left out in the model group. Ct imaging was performed at 412 weeks after operation to observe the repair of bone defect and to evaluate the new bone imaging score. The animals were killed at 812 weeks after operation. Alizarin red S and calmodulin were used for fluorescent labeling at 2 and 4 weeks after operation, and histomorphology was observed at 8 weeks after operation. Blood samples were collected from auricular vein before operation and 2 weeks after operation. Biochemical indexes and hemorheological indexes were measured. Results: the serum alkaline phosphatase (ALP) in the experimental animals was significantly higher than that before operation, and the ALP in the study group was significantly higher than that in the model group and the control group at 2 weeks after operation, and other biochemical indexes including glutamic oxaloacetic transaminase were significantly higher in the study group than in the model group and the control group. There was no significant difference in glutamate-pyruvic transaminase, urea nitrogen, creatinine and uric acid. Ct scan showed that at 12 weeks after operation, the local area of bone defect in the study group was filled with new bone tissue, and its density was almost the same as that of normal bone tissue. A small number of fragments of implant material can still be seen in the local bone defect. The imaging scores of new bone formation in the study group were higher than those in the control group at 4 weeks postoperatively (P 0.05). At 8 and 12 weeks after operation, the compressive strength of the femoral condylar defect in the study group was higher than that in the control group (P 0.05). The results of morphological study showed that the bone formation in the study group was significantly higher than that in the control group at 2 weeks, and the bone mineralization in the study group was significantly better than that in the control group at 4 weeks after operation. The results of hemorheology showed that the whole blood viscosity, plasma viscosity and platelet aggregation increased significantly after bone defect, and the whole blood viscosity, plasma viscosity and platelet aggregation rate of the study group were significantly lower than that of the control group (P 0.05) at 8 weeks after operation. Conclusion 0.5% calcium strontium sulfate can significantly promote the repair of cancellous bone defects, and can significantly improve the whole blood viscosity, plasma viscosity and platelet aggregation, which is superior to that of calcium sulfate alone. It is a good bone repair material.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R580;R683

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