根据Ⅰ型胶原氨基端末肽、Ⅰ型胶原羧基端末肽、骨钙素及骨特异性碱性磷酸酶早期诊断骨不连

发布时间：2018-05-07 21:16

  本文选题：骨折 + 骨钙素　； 参考：《中国组织工程研究》2016年51期

【摘要】：背景:对血液中骨代谢标志物的浓度进行检测以对骨折愈合情况进行评估具有使用简单、创伤小、变异小的特点,如何找到一种合适的标志物以预测骨不连的发生是当前该领域研究的热点。目的:建立骨折不愈合动物模型,探讨实验性骨折不愈合的生化指标变化规律。方法:选取五六月龄纯种新西兰大白兔20只,随机均分为2组,骨缺损组在左前臂桡骨中段截除1.5 cm(包括骨膜),骨断端用骨蜡封闭髓腔;骨折组只是在前臂桡骨中段造成骨折。2组分别于术前、术后2-8,10,12周进行前臂的X射线片检查观察桡骨缺损区愈合情况,并抽取血清采用生物素双抗体夹心ELISA法检测骨吸收特异标志物(包括Ⅰ型胶原羧基端末肽、Ⅰ型胶原氨基端末肽、人抗酒石酸酸性磷酸酶5b)及骨形成特异标志物(包括骨钙素、骨特异性碱性磷酸酶)的表达变化。结果与结论:1分析2组手术前后骨代谢指标的变化发现,骨缺损组骨代谢一直持续在较高水平,骨不连早期诊断的临床预测可以依赖于多个血清生化指标的同时跟踪监测;2除人抗酒石酸酸性磷酸酶5b意义不大之外,骨缺损组中I型胶原羧基端末肽在术后第5周均值最高,骨钙素、骨特异性碱性磷酸酶、Ⅰ型胶原氨基端末肽在术后4或5周均值明显下降,可以说明Ⅰ型胶原羧基端末肽、Ⅰ型胶原氨基端末肽、骨钙素、骨特异性碱性磷酸酶能快速随骨形成和骨吸收而迅速改变,敏感地反映体内骨代谢的具体状态;3系统性监测生化指标如Ⅰ型胶原羧基端末肽、骨钙素、骨特异性碱性磷酸酶、Ⅰ型胶原氨基端末肽的变化能反映兔骨折不愈合的早期进程,它们是否均可以作为反映骨吸收与骨形成的敏感性、特异性较强的指标,是否可以早期诊断兔骨不连,需要进一步深入探讨。
[Abstract]:Background: the detection of bone metabolic markers in blood to assess fracture healing is characterized by simple use, minimal trauma, and little variation. How to find a suitable marker to predict the occurrence of bone nonunion is a hot topic in this field. Objective: to establish an animal model of nonunion and to investigate the changes of biochemical indexes in experimental nonunion. Methods: twenty purebred New Zealand white rabbits aged five or six months were randomly divided into two groups: the bone defect group had 1.5 cm amputation at the middle segment of the radius of the left forearm (including periosteum, bone wax was used to seal the medullary cavity at the broken end of the bone; In the fracture group, the fracture occurred in the middle radius of the forearm, and the healing of the defect area of the radius was observed by X-ray examination of the forearm before operation and 2 ~ 810 ~ (th) weeks after operation. The specific markers of bone resorption (including type I collagen carboxyl terminal peptide, type I collagen amino terminal peptide, human tartrate resistant acid phosphatase 5b) and bone formation specific markers (including osteocalcin) were detected by biotin double antibody sandwich ELISA assay. The expression of bone specific alkaline phosphatase. Results and ConclusionThe changes of bone metabolism indexes before and after operation in the two groups were analyzed by 1: 1. It was found that bone metabolism in the bone defect group had been maintained at a high level. The clinical prediction of early diagnosis of bone nonunion can depend on multiple serum biochemical indexes and follow up and monitor. Except for the significance of human tartrate resistant acid phosphatase 5b, the carboxyl terminal peptide of type I collagen was the highest in the bone defect group at the 5th week after operation. The mean value of osteocalcin, bone specific alkaline phosphatase and type 鈪，

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