99Tc-MDP联合“骨康灵”治疗兔骨质疏松的生物力学研究
99Tc-MDP연합“골강령”치료토골질소송적생물역학연구
The biomechanics study of rabbit osteoporosis models treated by 99Tc-MDP combined with GuKang Ling
  • 万方数据
    中华核医学杂志 중화핵의학잡지
    CHINESE JOURNAL OF NUCLEAR MEDICINE
    2011年 5期 328-333 ,共6页

    高克加%赵国定%叶智卫%梅小刚%田英敏%严楚顺%王炜%李伟%蔡征宇%宋海萍

    고극가%조국정%협지위%매소강%전영민%엄초순%왕위%리위%채정우%송해평

    骨质疏松%MDP%中草药%生物力学%兔 骨質疏鬆%MDP%中草藥%生物力學%兔
    골질소송%MDP%중초약%생물역학%토
    Osteoporosis%MDP%Drugs%Chinese herbal%Biomechanics%Rabbits
    目的 探讨99Tc-MDP联合中药“骨康灵”治疗骨质疏松兔模型在治疗前后的骨生物力学变化.方法 制作兔骨质疏松动物模型(C组)与对照组(A组),以证实骨质疏松模型建立.设正常对照组(B组)和骨质疏松对照组(D组),用于在实验结束时对照；同时设99Tc-MDP治疗组(E组)、“骨康灵”治疗组(F组)和99Tc-MDP联合“骨康灵”治疗组(G组),治疗时间16周.疗效评判指标或方法:骨生物力学、细胞病理学、骨形态计量、骨密度、X线、CT、核素骨显像和血清骨碱性磷酸酶(BALP)、骨钙素(BGP)测定.疗效分为显效、有效和无效.采用SPSS 13.0软件,多组比较行方差分析,2组间比较采用t检验.结果 实验兔连续6周肌内注射地塞米松(按体质量2 mg/kg),A组病理细胞学切片无骨小梁破坏；C组实验兔病理切片见骨小梁排列稀疏、断裂,存在较明显的骨破坏现象,C组的骨生物力学[左股骨头为(265.914±52.773)N,第4腰椎L4为(369.671±94.919)N]、骨密度[左股骨头(0.238 ±0.016) g/cm2,L4 (0.236±0.016) g/cm2]、骨形态计量[(66.230±10.848)％]较A组[各指标依次为(405.343±55.410)N,(750.870±53.718)N,(0.294±0.017) g/cr2,(0.302±0.023) g/cm2,( 131.500±21.846)％]明显降低(t均≥4.550,P均＜0.01).核素骨显像示C组各大关节放射性摄取较A组明显增强,椎体显示不清；BALP、BGP与A组相比差异有统计学意义[分别为(45.000±7.303)比(12.485±1.512) U/L,(0.168 ±0.018)比(0.115±0.017) μg/L,t =4.126,5.476,P均＜0.01],证实兔骨质疏松模型成功建立.E组、F组、G组经16周治疗后,病理切片显示:E组、C组表现为骨组织结构和骨小梁明显得到修复,骨小梁增粗；F组修复较差.E组、G组骨生物力学指标[左股骨头分别为( 386.457±77.077)N和(432.771±17.525)N,L4分别为(649.550±126.859)N和(655.443±76.555)N]明显改善,骨显像表现与B组基本相似,而F组放射性摄取略低于D组.治疗后各组骨生物力学、骨形态计量、骨密度和血清BALP、BGP结果差异有统计学意义(F值8.556～31.608,P均＜0.01),G组的骨生物力学略强于E组(t=2.625,P＜0.05).疗效评判G组和E组均为显效,F组为有效.结论 99Tc-MDP联合“骨康灵”治疗兔骨质疏松在骨生物力学改善方面较明显,在提高骨抗外力的骨强度中可能有潜在的优势.
    목적 탐토99Tc-MDP연합중약“골강령”치료골질소송토모형재치료전후적골생물역학변화.방법 제작토골질소송동물모형(C조)여대조조(A조),이증실골질소송모형건립.설정상대조조(B조)화골질소송대조조(D조),용우재실험결속시대조；동시설99Tc-MDP치료조(E조)、“골강령”치료조(F조)화99Tc-MDP연합“골강령”치료조(G조),치료시간16주.료효평판지표혹방법:골생물역학、세포병이학、골형태계량、골밀도、X선、CT、핵소골현상화혈청골감성린산매(BALP)、골개소(BGP)측정.료효분위현효、유효화무효.채용SPSS 13.0연건,다조비교행방차분석,2조간비교채용t검험.결과 실험토련속6주기내주사지새미송(안체질량2 mg/kg),A조병리세포학절편무골소량파배；C조실험토병리절편견골소량배렬희소、단렬,존재교명현적골파배현상,C조적골생물역학[좌고골두위(265.914±52.773)N,제4요추L4위(369.671±94.919)N]、골밀도[좌고골두(0.238 ±0.016) g/cm2,L4 (0.236±0.016) g/cm2]、골형태계량[(66.230±10.848)％]교A조[각지표의차위(405.343±55.410)N,(750.870±53.718)N,(0.294±0.017) g/cr2,(0.302±0.023) g/cm2,( 131.500±21.846)％]명현강저(t균≥4.550,P균＜0.01).핵소골현상시C조각대관절방사성섭취교A조명현증강,추체현시불청；BALP、BGP여A조상비차이유통계학의의[분별위(45.000±7.303)비(12.485±1.512) U/L,(0.168 ±0.018)비(0.115±0.017) μg/L,t =4.126,5.476,P균＜0.01],증실토골질소송모형성공건립.E조、F조、G조경16주치료후,병리절편현시:E조、C조표현위골조직결구화골소량명현득도수복,골소량증조；F조수복교차.E조、G조골생물역학지표[좌고골두분별위( 386.457±77.077)N화(432.771±17.525)N,L4분별위(649.550±126.859)N화(655.443±76.555)N]명현개선,골현상표현여B조기본상사,이F조방사성섭취략저우D조.치료후각조골생물역학、골형태계량、골밀도화혈청BALP、BGP결과차이유통계학의의(F치8.556～31.608,P균＜0.01),G조적골생물역학략강우E조(t=2.625,P＜0.05).료효평판G조화E조균위현효,F조위유효.결론 99Tc-MDP연합“골강령”치료토골질소송재골생물역학개선방면교명현,재제고골항외력적골강도중가능유잠재적우세.
    Objective To study the bone biomechanics of the rabbit osteoporosis models induced by dexamethasone sodium phosphate injection (DX) using a combined treatment modality of 99Tc-MDP and GuKangLing.Methods Rabbits were intramuscularly injected with DX (2 mg/kg) twice a week for 6 weeks.The animal osteoporosis model group (Group C) and normal group (Group A) were compared to confirm the model was available.Another control group (Group B),the osteoporosis control group (Group D) were set for the comparison at the end of the experiment.The 99Tc-MDP therapy group (Group E),GuKangLing therapy group (Group F) and 99Tc-MDP plus GuKangLing therapy group (Group G) were included in the study.The treatment lasted for 16 weeks.The bone biomechanics,cytopathology bone histomorphology,bone mineral density (BMD),X-ray,CT,bone scintigraphy and serum bone alkaline phosphatase (BALP)and P (bone gla protein) were chosen as the markers or methods to evaluate the treatment results (excellent,effective and invalid).The analysis of variance (ANOVA) and t-test were used for group comparison analysis.Results Cytopathology result indicated that there was no bone trabecula destruction in Group A.However,there was distinct bone destruction in Group C.The bone biomechanics (left femur head (265.914 ±52.773) N,L4(369.671 ±94.919) N),BMD(left femur (0.238 ±0.016) g/cm2,L4(0.236 ±0.016) g/cm2)and bone histomorphology ( (66.230 ± 10.848) ％ ) in Group C reduced clearly as compared with Group A ((405.343±55.410) N,(750.870±53.718) N,(0.294±0.017) g/cm2,(0.302±0.023) g/cm2,( 131.500 ± 21.846) ％ ) ( t ≥4.550,all P ＜ 0.01 ).Radionuclide bone scan also showed that the uptake of tracers was higher by the main arthrosis in Group C than that in Group A.Vertebra was not clearly visualized on bone scan image.There were significant differences between Group A and Group C in serum BALP and P ((45.000±7.303) vs (12.485 ±1.512) U/L,(0.168±0.018) vs (0.115 ±0.017) μg/L,t =4.126,5.476,both P ＜ 0.01 ),which indicated that the animal osteoporosis model was available.The pathological results showed an improved recovery of bone structure and trabecular in Groups E and G,but a worse recovery in Group F.Biomechanics result in Groups E and G (left femur head (386.457 ±77.077) N and (432.771 ± 17.525) N,L4(649.550 ± 126.859) N and (655.443 ±76.555) N) improved apparently,which were similar to Group B.The radiotracer uptake in Group F was lower than that in group D.The bone biomechanics,bone histomorphology,BMD,serum BALP and P after the treatment showed significant differences in Groups E,F and G (F:8.556 - 31.608,all P＜0.01 ),and the bone biomechanics result in Group G was a little better than that in Group E (t =2.625,P ＜ 0.05 ).The results of Group G and E were considered as excellent,and Group F was considered as effective.Conclusions The treatment of 99Tc-MDP combined with GuKangLing could improve the bone biomechanics of rabbit osteoporosis models and may be a potential method to increase the bone strength for resisting external force.
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