Ⅰ型胶原N末端肽和定量CT骨密度早期测定实验性骨不连

发布时间：2018-10-05 20:42

【摘要】：背景:目前主要通过传统的X射线诊断骨折不愈合,这种方法仅依赖于临床医师的经验和骨折愈合中骨痂的矿化程度,易受投照、冲洗条件及主观因素影响,精确度欠佳。目的:建立骨折不愈合动物模型,检测其生化指标及骨密度变化规律。方法:将20只新西兰大白兔随机均分为2组,分别在前臂桡骨中段制作骨缺损模型与骨折模型,分别于术前、术后2,3,4,5,6,7,8,10,12周进行前臂的X射线检查、定量CT骨密度测定及血清学检测。结果与结论:X射线显示,骨缺损组中3只兔于术后第2周有少许骨痂形成,但5周后骨痂情况稳定,术后8周仍无愈合;骨折组术后2周开始骨折线模糊,术后6-8周骨痂大量生长。骨缺损组术后5周开始骨密度值明显下降,与骨折组比较差异显著。血清学检测显示,骨缺损组术后骨特异性碱性磷酸酶活性升高,第4周达到高峰,第5周时出现下降,第6周以后数值基本稳定;骨缺损组术后抗酒石酸酸性磷酸酶5b活性升高,在第4周出现峰值,然后下降,基本稳定;骨缺损组Ⅰ型胶原N末端肽在术后5周出现明显下降,术后6周以后基本稳定。说明系统性监测骨密度及生化指标如骨特异性碱性磷酸酶、抗酒石酸酸性磷酸酶5b和Ⅰ型胶原N末端肽的变化可能有助于反映兔骨折不愈合早期进程。
[Abstract]:Background: at present, the traditional X-ray diagnosis of fracture nonunion is mainly based on the experience of clinicians and the degree of callus mineralization in fracture healing. It is easy to be affected by radiation, irrigation conditions and subjective factors, and the accuracy is poor. Objective: to establish an animal model of fracture nonunion and to detect its biochemical indexes and bone mineral density (BMD). Methods: twenty New Zealand white rabbits were randomly divided into two groups. Bone defect model and fracture model were made in the middle radius of forearm. X-ray examination of forearm was performed before and after operation. Bone mineral density (BMD) and serum were measured by quantitative CT. Results and conclusion: in the bone defect group, there was a little callus formation in 3 rabbits at the second week after operation, but the callus was stable after 5 weeks, and the fracture line was blurred at the second week after operation, but the callus was still not healed 8 weeks after operation in the fracture group. A large number of callus grew 6-8 weeks after operation. Bone mineral density (BMD) decreased significantly in the bone defect group 5 weeks after operation, which was significantly different from that in the fracture group. The results of serological examination showed that the activity of bone specific alkaline phosphatase increased after operation in the bone defect group, reached the peak at the 4th week, decreased at the fifth week, and remained stable after 6 weeks. The activity of tartrate-resistant acid phosphatase 5b in the bone defect group increased after operation, peaked at the 4th week, then decreased, and the N-terminal peptide of type I collagen in the bone defect group decreased significantly at 5 weeks after operation, and remained stable after 6 weeks. These results suggest that systematic monitoring of bone mineral density and biochemical parameters such as bone specific alkaline phosphatase, tartrate-resistant acid phosphatase 5b and type I collagen N-terminal peptide may help to reflect the early stage of fracture nonunion in rabbits.
【作者单位】：海南省人民医院关节外科;南方医科大学南方医院关节外科;
【基金】：海南省自然科学基金资助课题(808212)~~
【分类号】：R318.08;R687.3

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