CAJ | 학술논문

目的探讨在兔骨缺损模型中骨膜对骨形态发生蛋白-2(BMP-2)分泌量及骨愈合的影响,以及保留骨膜的必要性. 方法选用良种新西兰大白兔48只(4个月龄,雌雄各24只)随机分成2组(n=24),在麻醉下手术造成兔左桡骨中段0.5 cm骨缺损,同时保留或切除骨缺损周围的骨膜以制成保留骨膜组和切除骨膜组,分别于术后即刻、术后1、3、4周各处死6只动物并摄骨缺损部位的X线片,对缺损部位的大体标本进行观察,并取缺损部位的组织进行Western blot检测,半定量测定BMP-2的含量,采用Lane-Sandhu X线评分标准对骨愈合进行量化评估.结果术后1、3、4周保留骨膜组兔骨缺损断端间组织中的BMP-2含量逐渐增多,均较术后即刻明显增加,差异有统计学意义(P＜0.05).切除骨膜组兔骨缺损断端间组织中的BMP-2含量在术后1周达最高峰,与术后即刻相比,差异有统计学意义(P＜0.05).术后1周两组BMP-2的含量相近,差异无统计学意义(P＞0.05)；术后3、4周保留骨膜组BMP-2的含量较切除骨膜组明显增多,差异均有统计学意义(P＜0.05).术后3、4周保留骨膜组的骨愈合Lane-Sandhu X线评分较切除骨膜组高,差异有统计学意义(P＜0.05).结论在骨缺损愈合过程中,骨膜的存在可以明显提高BMP-2的分泌量并促进骨缺损的愈合,在治疗骨缺损时保留骨膜具有重要意义.
목적 탐토재토골결손모형중골막대골형태발생단백-2(BMP-2)분비량급골유합적영향,이급보류골막적필요성. 방법 선용량충신서란대백토48지(4개월령,자웅각24지)수궤분성2조(n=24),재마취하수술조성토좌뇨골중단0.5 cm골결손,동시보류혹절제골결손주위적골막이제성보류골막조화절제골막조,분별우술후즉각、술후1、3、4주각처사6지동물병섭골결손부위적X선편,대결손부위적대체표본진행관찰,병취결손부위적조직진행Western blot검측,반정량측정BMP-2적함량,채용Lane-Sandhu X선평분표준대골유합진행양화평고.결과 술후1、3、4주보류골막조토골결손단단간조직중적BMP-2함량축점증다,균교술후즉각명현증가,차이유통계학의의(P＜0.05).절제골막조토골결손단단간조직중적BMP-2함량재술후1주체최고봉,여술후즉각상비,차이유통계학의의(P＜0.05).술후1주량조BMP-2적함량상근,차이무통계학의의(P＞0.05)；술후3、4주보류골막조BMP-2적함량교절제골막조명현증다,차이균유통계학의의(P＜0.05).술후3、4주보류골막조적골유합Lane-Sandhu X선평분교절제골막조고,차이유통계학의의(P＜0.05).결론 재골결손유합과정중,골막적존재가이명현제고BMP-2적분비량병촉진골결손적유합,재치료골결손시보류골막구유중요의의.
Objective To investigate the effect of bone membrane on secretion of bone morphogenetic protein-2(BMP-2) and bone healing in a rabbit model of bone defect.Methods Forty-eight New Zealand rabbits (4 months old,half male and half female) were randomly divided into 2 equal groups (n =24).A 0.5 cm bone defect of middle radius was created operatively under anesthesia in all the animals.The bone membrane around the defect was preserved in group A but exsected in group B.Six rabbits in each group were sacrificed each time at immediate,1,3 and 4 weeks post-operation.X-ray films of the bone defects were taken,gross observation of the tissue samples from the defect site was made,and semiquantitative detection of BMP-2 content by Western blotting was conducted at each time point.Quantitative assessment of bone healing was performed using Lane-Sandhu X-ray evaluation system.Results In group A,the amount of BMP-2 increased gradually at l,3,4 weeks postoperation,significantly higher than that at immediate postoperation (P ＜ 0.05).In group B,the amount of BMP-2 peaked at one week postoperation,significantly higher than that at immediate postoperation (P ＜ 0.05).At one week postoperation,there was no significant difference between the 2 groups in the amount of BMP-2 (P ＞ 0.05).At 3 and 4 weeks postoperation,the amount of BMP-2 in group A was significantly higher than in group B (P ＜ 0.05) and the mean Lane-Sandhu X-ray score in group A was also significantly higher than in group B (P ＜ 0.05).Conclusion Since preservation of bone membrane increases secretion of BMP-2 and promotes bone healing in the healing process of bone defect,we should try to preserve bone membrane when bone defects are treated.