背景:骨质疏松是脊髓损伤的常见并发症之一,其确切机制尚未完全清楚,损伤平面上下骨质是否均发生骨质疏松,不同学者观点不同.目的:观察脊髓损伤后继发骨质疏松的骨组织超微结构、血液生化改变情况,分析损伤平面上下骨质受累情况和程度.设计:随机对照实验.单位:吉林大学第二临床医院动物试验室,吉林大学第二临床医院检验科,吉林大学白求恩医学部电镜教研室.材料:实验于2002-05/2003-05在吉林大学第二临床医院动物试验室完成.Wistar大鼠110只,均为雄性,四五月龄,体质量为300～320g.方法:110只Wistar雄性大鼠随机选取10只为0周空白对照组,将余下大鼠随机分为实验组和对照组,1,2,3,7,11周对照组及实验组每组各10只.用1 mL/L戊巴比妥钠腹腔注射麻醉,对照组仅行T10椎板切除不破坏硬膜,不损伤脊髓,实验组大鼠于T10椎体水平切除椎板,行Allen's法损伤脊髓.分别于0周、术后1周,2周,3周,7周,11周周末将动物下腔静脉采血4mL后麻醉状态下处死,血液离心,应用7170A HI-TACHI自动生化分析仪自动采样化验血钙、血磷的含量及碱性磷酸酶活性.另取0周空白对照组,7周实验组,11周实验组右侧肱骨、胫骨各一用25 mL/L乙二胺四乙酸脱钙1个月后制备切片,在醋酸双氧铀及柠檬酸双重染色下应用JEM-1200型透射电子显微镜观察肱骨外科颈、胫骨平台部以骨细胞为主的超微结构改变情况.结果:进入结果分析的大鼠为105只.①血生化检查结果:实验2周时血磷含量对照组明显低于实验组[(1.54±0.21),(2.76±0.16)mmol/L,(P＜0.01)];实验3周时血钙含量实验组明显高于对照组[(2.52±0.06),(2.35±0.12)mmol/L,(P＜0.01)];实验7周时碱性磷酸酶活性实验组明显高于对照组[(155.86±20.42),(129.25±7.30)Nμ/mg,(P＜0.01)].②电子显微镜下观察结果:术后7周实验组胫骨标本可见骨细胞与骨陷窝分离,个别细胞胞核不规则,可见絮状物质、线立体粗面内质网肿胀开空化;11周时,可见骨细胞与骨陷窝严重分离.术后7周实验组肱骨标本可见骨细胞与骨陷窝分离,有的细胞核固缩粗面内质网肿胀空化;11周时仍见上述改变,但细胞肿胀空化程度减轻.结论:脊髓损伤早期破骨细胞活性增强,成骨细胞活性降低,导致骨吸收增强,骨形成减弱.鼠损伤平面上下骨质均受累,但不同部位的骨骼继发骨质疏松的程度不同,骨质疏松后骨细胞超微结构改变显著.
揹景:骨質疏鬆是脊髓損傷的常見併髮癥之一,其確切機製尚未完全清楚,損傷平麵上下骨質是否均髮生骨質疏鬆,不同學者觀點不同.目的:觀察脊髓損傷後繼髮骨質疏鬆的骨組織超微結構、血液生化改變情況,分析損傷平麵上下骨質受纍情況和程度.設計:隨機對照實驗.單位:吉林大學第二臨床醫院動物試驗室,吉林大學第二臨床醫院檢驗科,吉林大學白求恩醫學部電鏡教研室.材料:實驗于2002-05/2003-05在吉林大學第二臨床醫院動物試驗室完成.Wistar大鼠110隻,均為雄性,四五月齡,體質量為300～320g.方法:110隻Wistar雄性大鼠隨機選取10隻為0週空白對照組,將餘下大鼠隨機分為實驗組和對照組,1,2,3,7,11週對照組及實驗組每組各10隻.用1 mL/L戊巴比妥鈉腹腔註射痳醉,對照組僅行T10椎闆切除不破壞硬膜,不損傷脊髓,實驗組大鼠于T10椎體水平切除椎闆,行Allen's法損傷脊髓.分彆于0週、術後1週,2週,3週,7週,11週週末將動物下腔靜脈採血4mL後痳醉狀態下處死,血液離心,應用7170A HI-TACHI自動生化分析儀自動採樣化驗血鈣、血燐的含量及堿性燐痠酶活性.另取0週空白對照組,7週實驗組,11週實驗組右側肱骨、脛骨各一用25 mL/L乙二胺四乙痠脫鈣1箇月後製備切片,在醋痠雙氧鈾及檸檬痠雙重染色下應用JEM-1200型透射電子顯微鏡觀察肱骨外科頸、脛骨平檯部以骨細胞為主的超微結構改變情況.結果:進入結果分析的大鼠為105隻.①血生化檢查結果:實驗2週時血燐含量對照組明顯低于實驗組[(1.54±0.21),(2.76±0.16)mmol/L,(P＜0.01)];實驗3週時血鈣含量實驗組明顯高于對照組[(2.52±0.06),(2.35±0.12)mmol/L,(P＜0.01)];實驗7週時堿性燐痠酶活性實驗組明顯高于對照組[(155.86±20.42),(129.25±7.30)Nμ/mg,(P＜0.01)].②電子顯微鏡下觀察結果:術後7週實驗組脛骨標本可見骨細胞與骨陷窩分離,箇彆細胞胞覈不規則,可見絮狀物質、線立體粗麵內質網腫脹開空化;11週時,可見骨細胞與骨陷窩嚴重分離.術後7週實驗組肱骨標本可見骨細胞與骨陷窩分離,有的細胞覈固縮粗麵內質網腫脹空化;11週時仍見上述改變,但細胞腫脹空化程度減輕.結論:脊髓損傷早期破骨細胞活性增彊,成骨細胞活性降低,導緻骨吸收增彊,骨形成減弱.鼠損傷平麵上下骨質均受纍,但不同部位的骨骼繼髮骨質疏鬆的程度不同,骨質疏鬆後骨細胞超微結構改變顯著.
배경:골질소송시척수손상적상견병발증지일,기학절궤제상미완전청초,손상평면상하골질시부균발생골질소송,불동학자관점불동.목적:관찰척수손상후계발골질소송적골조직초미결구、혈액생화개변정황,분석손상평면상하골질수루정황화정도.설계:수궤대조실험.단위:길림대학제이림상의원동물시험실,길림대학제이림상의원검험과,길림대학백구은의학부전경교연실.재료:실험우2002-05/2003-05재길림대학제이림상의원동물시험실완성.Wistar대서110지,균위웅성,사오월령,체질량위300～320g.방법:110지Wistar웅성대서수궤선취10지위0주공백대조조,장여하대서수궤분위실험조화대조조,1,2,3,7,11주대조조급실험조매조각10지.용1 mL/L무파비타납복강주사마취,대조조부행T10추판절제불파배경막,불손상척수,실험조대서우T10추체수평절제추판,행Allen's법손상척수.분별우0주、술후1주,2주,3주,7주,11주주말장동물하강정맥채혈4mL후마취상태하처사,혈액리심,응용7170A HI-TACHI자동생화분석의자동채양화험혈개、혈린적함량급감성린산매활성.령취0주공백대조조,7주실험조,11주실험조우측굉골、경골각일용25 mL/L을이알사을산탈개1개월후제비절편,재작산쌍양유급저몽산쌍중염색하응용JEM-1200형투사전자현미경관찰굉골외과경、경골평태부이골세포위주적초미결구개변정황.결과:진입결과분석적대서위105지.①혈생화검사결과:실험2주시혈린함량대조조명현저우실험조[(1.54±0.21),(2.76±0.16)mmol/L,(P＜0.01)];실험3주시혈개함량실험조명현고우대조조[(2.52±0.06),(2.35±0.12)mmol/L,(P＜0.01)];실험7주시감성린산매활성실험조명현고우대조조[(155.86±20.42),(129.25±7.30)Nμ/mg,(P＜0.01)].②전자현미경하관찰결과:술후7주실험조경골표본가견골세포여골함와분리,개별세포포핵불규칙,가견서상물질、선입체조면내질망종창개공화;11주시,가견골세포여골함와엄중분리.술후7주실험조굉골표본가견골세포여골함와분리,유적세포핵고축조면내질망종창공화;11주시잉견상술개변,단세포종창공화정도감경.결론:척수손상조기파골세포활성증강,성골세포활성강저,도치골흡수증강,골형성감약.서손상평면상하골질균수루,단불동부위적골격계발골질소송적정도불동,골질소송후골세포초미결구개변현저.
BACKGROUND: Osteoporosis is one of the complications of spinal cord injury, but its mechanism is unclear, different scholars have different points about whether all bones above and below the level of trauma are affected after spinal cord injury (SCI).OBJECTIVE: To observe the ultrastructure of bone tissue of secondary osteoporosis after spinal cord injury and the change of serum biochemical indexes, to analyze the suffered condition and injured degree of the bones above and below the level of the trauma.DESIGN: Randomized controlled experimentSETTING: Laboratory of Animals, and Department of Laboratory Medicine of the Second Clinical Hospital of Jilin University; Transmission Electron Microscope Center, Norman Bethune Division of Medical Sciences of Jilin UniversityMATERIALS: This experiment was conducted at the Laboratory of Animals, Second Clinical Hospital of Jilin University from May 2002 to May 2003. Totally 110 male Wistar rats, aged 4 to 5 month-old, with the body mass of (300 -320)g were involved.METHODS: Ten rats were randomly chosen from 110 male Wistar rats and were set as 0 week blank control group, the ther rats were randomly divided into experimental group and control group, there were 10 rats in week 1, 2, 3, 7 and 11 control group and experimental group separately.1 mL/L of pentobarbital natrium was intraperitoneal injected to perform anesthesia, in the control group, lamina with dura intact of rats were removed only, without spinal cord injury at the level of tenth thoracic vertebrae. In the experimental group, lamina of rats was also removed, the spinal cord injury model of the rats were made by the method of Allen's.4 mL venous blood was collected from the animals at the end of postoperative week 0, week 1, week 2, week 3, week 7 and week 11, then the animals were put to death, perform blood centrifuging .We observe the change of serum concentration of calcium, phosphorus and alkaline phophatase (ALP) with 7170A HITACHI auto-biochemistry analyzer. Right side humerus, tibia in week 0 blank control group, week 7 experimental group and week 11 experimental group were chosen, then 25 mL/L ethylene dinitrilotetraacetic acid was used for decalcium for 1 month for preparingthe sections. We observe the change of ultrastructure of osteocytes at the sites of tibial plateau and the surgical neck of the humerus after stained by uranyl acetate and lead citrate under transmission electron microscope.biochemistry detection: the level of phosphorus at week 2 of the experiment was significantly lower in the control group than experiment group [(1.54±0.21),(2.76±0.16)mmol/L, (P ＜ 0.01)]; the level of calcium at week 3 in the experiment group was significantly higher than in the control group [(2.52±0.06),(2.35±0.12)mmol/L, (P ＜ 0.01)];the level of alkaline phophatase at week 7 in the experiment group was significantly higher than in the control group [(155.86±20.42), (129.25±7.30)Nμ/mg,operative week 7, the tibia sample showed that the osteocyte separated from the osseous lacuna, the nucleus showed anomaly, fluffed materials appeared. Mitochondrion swelled, rough endoplasmic hollowed; At week 11, osteocyte separated from the osseous lacuna. At postoperative 7 week,the humerus sample showed that osteocyte separated from osseous lacuna,some nucleus pycnosis and rough endoplasmic hollowed; At postoperative week 11, the above changes still were seen, but the degree of cellular swelling and hollowing were lighten.CONCLUSION: At the early stage of spinal cord injury, the activity of osteoclast is increased and the activity of osteoblast is decreased, which leads to the increase of bone absorption, the bone formation is largely weakened. The bones above and below the level of trauma are both affected after spinal cord injury, but different extents of osteoporosis can be seen in different bones .The change of ultrastructure of osteocytes is remarkable when osteoporosis has happened.
