胫骨延长对肌肉的影响及IGF-1在其中作用

发布时间：2018-03-27 15:26

本文选题：骨延长术　切入点：胰岛素样生长因子-1　出处：《天津医科大学》2015年硕士论文

【摘要】：目的:骨延长术是一种主要被用于纠正各种原因,包括先天发育不良、创伤、骨肿瘤等引起的骨短缩或骨缺失的手术技术。通过将骨断端之间的距离缓慢延长达到形成新骨的目的。然而,延长周围软组织不能适应延长会造成软组织,特别是肌肉相关的并发症发生。胰岛素样生长因子-1作为一种体内广泛存在的促生长因子,被认为是肌肉组织中主要的调节肌肉损伤修复的细胞因子。本实验主要评估胫骨延长术中胫前肌和腓肠肌在延长期间的变化,探究胰岛素样生长因子-1是否可以增加腓肠肌在延长期间的适应能力。方法:(1)使用80只8周龄的S-D大鼠,制作胫骨骨折延长模型。将80只模型鼠随机分为对照组和延长组。在延长后第1、4、7和10天分别取延长组大鼠胫前肌和腓肠肌,对照组在相同时间取材。测量肌肉重量,肌纤维横截面积,最大被动牵张力和刚度,以及相关基因Myo D、myogenin和myostatin的表达情况。(2)选取102只S-D大鼠,其中96只制作胫骨骨折延长模型。将制作的动物模型随机分为生理盐水注射组和胰岛素样生长因子-1注射组。未处理的大鼠为对照组。在延长之前,胰岛素样生长因子-1注射组的大鼠皮下注射胰岛素样生长因子-1,之后隔天注射。生理盐水注射组在与胰岛素样生长因子-1注射的相同时间注射等量的生理盐水。在延长第1、4、7和10天取两组大鼠腓肠肌。对照组在其他两组延长开始之间处死取材。测量肌肉重量,肌纤维横截面积,胶原容积分数,最大被动牵张力和最大主动收缩力和相关基因Akt、Myo D、myogenin和myostatin的表达情况。结果:(1)延长组胫前肌和腓肠肌都随着延长而增加,但是在延长结束时仍低于正常。在延长组,胫前肌的最大被动牵张力增加明显,然而,腓肠肌的略有降低。刚度在延长组的两种肌肉中都表现出增加。Myo D和myogenin随着延长出现显著上调,myostatin下调。(2)胰岛素样生长因子的注射促进肌肉重量增加。与对生理盐水注射组的肌纤维横截面积相比,胰岛素样生长因子-1注射组的显著增加。在肌肉力学性能方面,胰岛素样生长因子-1不论是被动牵张力还是主动收缩力,相比于生理盐水组都是增加的。Akt、Myo D和myogenin表现出上调,而myostatin表达量下降。结论:(1)胫骨延长术可以改变延长部位胫前肌和腓肠肌形态学和力学性能改变。这种改变是不良的。胫前肌和腓肠肌对胫骨延长有一定的适应能力,并且胫前肌比腓肠肌的适应要好。(2)胰岛素样生长因子-1可以增加腓肠肌在胫骨延长术中的适应能力。注射外源性的胰岛素样生长因子-1可以减轻肌肉萎缩,阻止肌肉纤维化的发生,增加肌肉被动牵张力。胰岛素样生长因子-1在胫骨延长期间对肌肉的作用主要是调节肌肉代谢相关基因的表达实现的。
[Abstract]:Objective: bone lengthening is a major method used to correct various causes, including congenital dysplasia, trauma, Surgical techniques for bone shortening or bone loss caused by bone neoplasms. The formation of a new bone is achieved by slowly lengthening the distance between the broken ends of the bone. However, prolonging the surrounding soft tissue can result in soft tissue if it is not adapted to the lengthening. In particular, muscle-related complications occur. Insulin-like growth factor-1 (IGF-1) is widely present in the body as a growth promoting factor. This study was designed to evaluate the changes of the anterior tibial muscle and gastrocnemius muscle during the lengthening of the tibia. To investigate whether insulin-like growth factor-1 could increase the adaptability of gastrocnemius muscle during the prolonged period. Methods 80 8-week-old S-D rats were treated with 1: 1. 80 rats were randomly divided into control group and lengthening group. The tibial anterior muscle and gastrocnemius muscle were taken from the lengthened group on the 7th and 10th day after the lengthening, and the muscle weight was measured at the same time in the control group, and the tibial anterior muscle and gastrocnemius muscle were taken from the rats in the control group at the same time. The muscle fiber cross-sectional area, maximum passive stretch and stiffness, and the expression of Myo dymyogenin and myostatin were selected in 102 S-D rats. 96 of the animals were randomly divided into saline injection group and insulin-like growth factor-1 injection group. Untreated rats were used as control group. Rats in the insulin-like growth factor-1 injection group were subcutaneously injected with insulin-like growth factor-1 and then injected every other day. The saline injection group received the same amount of normal saline at the same time as the insulin-like growth factor-1 injection group. Gastrocnemius muscle was taken from rats on the 7th and 10th day after the first extension. The control group was killed between the other two groups and the muscle weight was measured. Muscle fiber cross-sectional area, collagen volume fraction, maximal passive tension, maximal active contractility and the expression of Aktnolia danmyogenin and myostatin. Results the tibial anterior muscle and gastrocnemius muscle increased with the prolongation. However, at the end of the extension, the maximal passive tension of the anterior tibial muscle increased significantly. The stiffness of gastrocnemius muscle increased slightly in both groups. Myo D and myogenin increased significantly with prolongation) the injection of insulin-like growth factor promoted the increase of muscle weight. Compared with the cross-sectional area of muscle fibers in the water injection group, In terms of muscle mechanical properties, insulin-like growth factor-1 (IGF-1) was up-regulated both in passive tension and active contractility, compared with that in saline group. Conclusion tibial lengthening can change the morphological and mechanical properties of tibial anterior muscle and gastrocnemius muscle, which is not good. Tibial anterior muscle and gastrocnemius muscle have some adaptability to tibial lengthening. Furthermore, the anterior tibial muscle was more adaptable than gastrocnemius muscle.) insulin-like growth factor-1 increased the adaptability of gastrocnemius muscle in tibial lengthening. Injection of exogenous insulin-like growth factor -1 reduced muscle atrophy. The effect of insulin-like growth factor-1 on muscle during tibial lengthening is mainly due to the regulation of the expression of metabolism-related genes in muscle.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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