中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2013年
51期
8827-8833
,共7页
席光伟%王学玲%宫琳%孟宪敏%张俊山%田发明
席光偉%王學玲%宮琳%孟憲敏%張俊山%田髮明
석광위%왕학령%궁림%맹헌민%장준산%전발명
生物材料%组织工程骨材料%骨质疏松%骨折愈合%辛伐他汀%生物涂层%骨密度
生物材料%組織工程骨材料%骨質疏鬆%骨摺愈閤%辛伐他汀%生物塗層%骨密度
생물재료%조직공정골재료%골질소송%골절유합%신벌타정%생물도층%골밀도
背景：降脂类药物辛伐他汀具有一定的促进骨形成作用潜能，局部应用效果更佳。先前研究对骨质疏松大鼠骨折愈合中期的观察证实辛伐他汀涂层内固定可促进骨质疏松大鼠骨折愈合，但其对骨折愈合晚期的影响未见报道。<br> 目的：观察局部应用辛伐他汀涂层内固定对骨质疏松大鼠骨折愈合晚期进程的影响。<br> 方法：将雌性 SD 大鼠分为单纯骨折组、骨质疏松性骨折组及辛伐他汀干预组。单纯骨折组仅暴露腹腔卵巢不予切除，其余2组采用双侧卵巢切除法建立骨质疏松模型。卵巢切除后6周，所有大鼠建立股骨中段开放性骨折模型，单纯骨折组、骨质疏松性骨折组及辛伐他汀干预组分别采用无涂层、聚乳酸涂层和辛伐他汀复合聚乳酸涂层克氏针内固定。骨折造模后12周分析骨折侧股骨骨密度，X射线摄片和苏木精-伊红染色分析骨折愈合情况，免疫组织化学分析骨形态发生蛋白2在骨折局部的表达。<br> 结果与结论：骨密度检测结果提示股骨全长及中段骨密度骨质疏松性骨折组、辛伐他汀干预组显著低于单纯骨折组，辛伐他汀干预组骨折部位骨密度显著高于骨质疏松性骨折组。X 射线摄片结果提示，单纯骨折组骨折两端对位、对线良好，骨痂与骨皮质密度接近相同并相互连接，塑形基本完成；骨质疏松性骨折组愈合质量差，骨痂密度浅淡，部分标本仍见模糊的骨折线；辛伐他汀干预组骨折线消失，骨痂填满骨缺损，骨膜反应深，单纯骨折组、辛伐他汀干预组X射线评分显著高于骨质疏松性骨折组(P <0.05)。苏木精-伊红染色提示，骨质疏松性骨折组骨折愈合进程较单纯骨折组延迟，辛伐他汀干预组骨小梁较骨质疏松性骨折组更规则有序。免疫组化结果提示各组大鼠骨形态发生蛋白2的表达水平差异无显著性意义。提示辛伐他汀局部应用可有效促进骨质疏松大鼠骨折愈合。
揹景：降脂類藥物辛伐他汀具有一定的促進骨形成作用潛能，跼部應用效果更佳。先前研究對骨質疏鬆大鼠骨摺愈閤中期的觀察證實辛伐他汀塗層內固定可促進骨質疏鬆大鼠骨摺愈閤，但其對骨摺愈閤晚期的影響未見報道。<br> 目的：觀察跼部應用辛伐他汀塗層內固定對骨質疏鬆大鼠骨摺愈閤晚期進程的影響。<br> 方法：將雌性 SD 大鼠分為單純骨摺組、骨質疏鬆性骨摺組及辛伐他汀榦預組。單純骨摺組僅暴露腹腔卵巢不予切除，其餘2組採用雙側卵巢切除法建立骨質疏鬆模型。卵巢切除後6週，所有大鼠建立股骨中段開放性骨摺模型，單純骨摺組、骨質疏鬆性骨摺組及辛伐他汀榦預組分彆採用無塗層、聚乳痠塗層和辛伐他汀複閤聚乳痠塗層剋氏針內固定。骨摺造模後12週分析骨摺側股骨骨密度，X射線攝片和囌木精-伊紅染色分析骨摺愈閤情況，免疫組織化學分析骨形態髮生蛋白2在骨摺跼部的錶達。<br> 結果與結論：骨密度檢測結果提示股骨全長及中段骨密度骨質疏鬆性骨摺組、辛伐他汀榦預組顯著低于單純骨摺組，辛伐他汀榦預組骨摺部位骨密度顯著高于骨質疏鬆性骨摺組。X 射線攝片結果提示，單純骨摺組骨摺兩耑對位、對線良好，骨痂與骨皮質密度接近相同併相互連接，塑形基本完成；骨質疏鬆性骨摺組愈閤質量差，骨痂密度淺淡，部分標本仍見模糊的骨摺線；辛伐他汀榦預組骨摺線消失，骨痂填滿骨缺損，骨膜反應深，單純骨摺組、辛伐他汀榦預組X射線評分顯著高于骨質疏鬆性骨摺組(P <0.05)。囌木精-伊紅染色提示，骨質疏鬆性骨摺組骨摺愈閤進程較單純骨摺組延遲，辛伐他汀榦預組骨小樑較骨質疏鬆性骨摺組更規則有序。免疫組化結果提示各組大鼠骨形態髮生蛋白2的錶達水平差異無顯著性意義。提示辛伐他汀跼部應用可有效促進骨質疏鬆大鼠骨摺愈閤。
배경：강지류약물신벌타정구유일정적촉진골형성작용잠능，국부응용효과경가。선전연구대골질소송대서골절유합중기적관찰증실신벌타정도층내고정가촉진골질소송대서골절유합，단기대골절유합만기적영향미견보도。<br> 목적：관찰국부응용신벌타정도층내고정대골질소송대서골절유합만기진정적영향。<br> 방법：장자성 SD 대서분위단순골절조、골질소송성골절조급신벌타정간예조。단순골절조부폭로복강란소불여절제，기여2조채용쌍측란소절제법건립골질소송모형。란소절제후6주，소유대서건립고골중단개방성골절모형，단순골절조、골질소송성골절조급신벌타정간예조분별채용무도층、취유산도층화신벌타정복합취유산도층극씨침내고정。골절조모후12주분석골절측고골골밀도，X사선섭편화소목정-이홍염색분석골절유합정황，면역조직화학분석골형태발생단백2재골절국부적표체。<br> 결과여결론：골밀도검측결과제시고골전장급중단골밀도골질소송성골절조、신벌타정간예조현저저우단순골절조，신벌타정간예조골절부위골밀도현저고우골질소송성골절조。X 사선섭편결과제시，단순골절조골절량단대위、대선량호，골가여골피질밀도접근상동병상호련접，소형기본완성；골질소송성골절조유합질량차，골가밀도천담，부분표본잉견모호적골절선；신벌타정간예조골절선소실，골가전만골결손，골막반응심，단순골절조、신벌타정간예조X사선평분현저고우골질소송성골절조(P <0.05)。소목정-이홍염색제시，골질소송성골절조골절유합진정교단순골절조연지，신벌타정간예조골소량교골질소송성골절조경규칙유서。면역조화결과제시각조대서골형태발생단백2적표체수평차이무현저성의의。제시신벌타정국부응용가유효촉진골질소송대서골절유합。
BACKGROUND:As a lipid-lowering drug, simvastatin has been proved to be effective in promoting bone formation. Previous studies have demonstrated that local y applied simvastation accelerated fracture healing at middle phase in osteoporotic rats, while no study focuses on the influence of local y applied simvastatin on fracture healing at late period in an osteoporotic rat. <br> OBJECTIVE:To investigate the effect of simvastatin local y applied from a bioactive polymer coating of implants on osteoporotic fracture healing at late period. <br> METHODS:Female Sprague-Dawley rats were divided into sham group, osteoporotic fracture group and simvastatin group. In the sham group, the abdominal cavity was exposed without ovariectomy. Six weeks later, femur fracture models were established in normal or osteotoporotic Sprague-Dawley rats, and intramedul ary stabilization was achieved with uncoated titanium Kirschner wires in normal rats (sham group),with polylactic acid coated titanium Kirschner wires (osteoporotic fracture group) and with simvastatin/polylactic acid coated titanium Kirschner wires (simvastatin group). Femurs were harvested after 12 weeks, bone mineral density was determined with dual X-ray absorptiometry, and then radiographic and histological analysis was performed for analysis of fracture healing. Immunohistochemical evaluation was employed for bone morphogenetic protein 2 expression. <br> RESULTS AND CONCLUSION:The bone mineral densities of both the total fractured femur and fractured site 12 weeks after fracture in the osteoporotic fracture group and simvastatin group were markedly decreased compared to normal fractured rats. The bone mineral density of the fractured site was significantly higher in the simvastatin group than the osteoporotic fracture group. Radiographic results demonstrated completely finished cal us remodeling in the sham group;poor healing, pale cal us density and blurred fracture line were seen in the osteoporotic fracture group;disappearance of fracture line, bone defects fil ed with cal us, and deep periosteal reaction were found in the simvastatin group. X-ray scores in the sham and simvastatin groups were significantly higher than that in the osteoporotic group (P<0.05). Hematoxylin-eosin staining showed a delayed healing process in the osteoporotic group, and revealed a significantly processed cal us with regular-shaped newly formed bone trabeculae in the simvastatin group. Immunohistochemical evaluation showed no significant difference in the bone morphogenetic protein 2 expression between any two groups. These findings suggest an improved fracture healing under local application of simvastatin in osteoporotic rats.
