CAJ | 학술논문

目的探索血糖波动对2型糖尿病大鼠种植体骨结合的影响，为糖尿病患者种植失败率高的机制研究提供新的思路。方法24只SD大鼠分为正常对照组、持续高血糖组和血糖波动组，正常对照组自由摄食普通饲料，两实验组采用高脂高糖饮食配合小剂量腹腔注射STZ建造成2型糖尿病大鼠模型，其中一组自由摄食高脂高糖饲料，为持续性高血糖组，另一组进行饮食控制，每天禁食12 h，造成日内大幅度的血糖波动，为血糖波动组，4周时分别对各组大鼠进行糖耐量试验。于3组大鼠右侧胫骨骺端植入经微弧氧化技术处理过的纯钛种植体一枚，分别于4周、8周处死大鼠，取右侧胫骨，制作含种植体的不脱钙硬组织切片进行组织形态学观察，分析种植体骨结合情况。结果实验组大鼠糖耐量均出现异常，且血糖波动组糖负荷后各时间点血糖均高于持续性高血糖组（ P＜0.05）。术后4周，持续高血糖组与血糖波动组骨结合情况相似（P＞0.05），均明显差于正常对照组（P＜0.05），术后8周，血糖波动组骨结合情况差于持续性高血糖组，3组之间骨结合情况均差异明显（ P＜0.05）。结论血糖波动对2型糖尿病大鼠种植体骨结合有抑制作用，且该作用影响大于持续性高血糖。
목적탐색혈당파동대2형당뇨병대서충식체골결합적영향，위당뇨병환자충식실패솔고적궤제연구제공신적사로。방법24지SD대서분위정상대조조、지속고혈당조화혈당파동조，정상대조조자유섭식보통사료，량실험조채용고지고당음식배합소제량복강주사STZ건조성2형당뇨병대서모형，기중일조자유섭식고지고당사료，위지속성고혈당조，령일조진행음식공제，매천금식12 h，조성일내대폭도적혈당파동，위혈당파동조，4주시분별대각조대서진행당내량시험。우3조대서우측경골후단식입경미호양화기술처리과적순태충식체일매，분별우4주、8주처사대서，취우측경골，제작함충식체적불탈개경조직절편진행조직형태학관찰，분석충식체골결합정황。결과실험조대서당내량균출현이상，차혈당파동조당부하후각시간점혈당균고우지속성고혈당조（ P＜0.05）。술후4주，지속고혈당조여혈당파동조골결합정황상사（P＞0.05），균명현차우정상대조조（P＜0.05），술후8주，혈당파동조골결합정황차우지속성고혈당조，3조지간골결합정황균차이명현（ P＜0.05）。결론혈당파동대2형당뇨병대서충식체골결합유억제작용，차해작용영향대우지속성고혈당。
Objective To provide new ideas for the study of mechanism about the high failure rate for the dental implant of diabetic patients by exploring the effect of blood glucose fluctuation on osseointegration around implant in type 2 diabetic rats .Methods Twenty-four male Sprague Dawley rats had been divided into three groups randomly.One of them was normal control group ,in which the rats were fed with common diet ,and the rats in the other two groups were made type 2 diabetes animal model by high fat and sugar feeds and combined with an intraperitoneal injection of streptozotocin in a low dose .Then one of the tow experimental groups was feed with high fat and sugar diet normally as consistent high blood glucose group ,and another group was feed the same diet every 12 hours as intermittent high blood glucose group .A titanium implant treated by micro-arcoxidation surface was planted into the right tibia bone of every rat .Killed the rats and harvested the tibia containing implants respectively at 4 and 8 weeks,and analysed the osseointegration by the undecalcified tissue slices .Results After glucose charge,the glucose level of the glucose fluctuation group at every point-in-time was significantly higher than that of the other groups(P<0.05).At 4 weeks,the percentage of bone-implant contact(BIC)in glucose fluctuation group was similar to consistent high blood glucose group ( P>0.05 ) ,and the BIC in both experimental groups was less than in normal control group(P<0.05).At 8 weeks,the BIC in glucose fluctuation group was less than in consistent high blood glucose group ( P<0.05 ) .Conclusions Blood glucose fluctuation could restrain the osseointegration around implant in type 2 diabetic rats ,and the effect may be obvious than consistent high blood glucose .