中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2013年
6期
657-663
,共7页
杨宁%崔岳毅%宋纯理%田耘%冷慧杰%陈仲强%刘忠军%党耕町
楊寧%崔嶽毅%宋純理%田耘%冷慧傑%陳仲彊%劉忠軍%黨耕町
양저%최악의%송순리%전운%랭혜걸%진중강%류충군%당경정
骨质疏松%骨折固定术,内%斯伐他汀%骨整合
骨質疏鬆%骨摺固定術,內%斯伐他汀%骨整閤
골질소송%골절고정술,내%사벌타정%골정합
Osteoporosis%Fracture fixation,internal%Simvastatin%Osseointegration
目的 探讨疏松骨骼局部注射辛伐他汀对内固定强度的影响及其作用机制.方法 取3月龄雌性SD大鼠24只,切除双侧卵巢制备大鼠骨质疏松模型.3个月后将动物随机分为三组.右侧股骨髁植入钛合金螺钉后于髓腔内分别注射5 mg、10 mg辛伐他汀或空白PBS缓冲液.术后1个月行骨密度测定、螺钉周围骨微结构定量分析,测定螺钉最大载荷,通过免疫组织化学染色观察BMP-2的表达.结果 辛伐他汀5 mg组、10 mg组骨密度分别为(201±23.3)、(207.9±23.5) mg/cm2,与空白PBS缓冲液组(170.8±13.8) mg/cm2比较差异有统计学意义；螺钉骨整合率分别为51.4％±3.0％、52.6％±4.1％,较空白PBS缓冲液组(27.3％±4.9％)增加,螺钉周边各项骨微结构指标均改善,差异有统计学意义；螺钉的最大载荷分别为(161.5±9.4)、(161.9±11.4)N,高于空白PBS缓冲液组(145.7±9.6)N,差异有统计学意义；BMP-2的表达较空白PBS缓冲液组增强.结论 疏松骨骼局部单次注射小剂量辛伐他汀可促进内植物周边的骨整合,增强内固定的稳定性；其作用机制与局部注射辛伐他汀促进BMP-2的高表达有关.
目的 探討疏鬆骨骼跼部註射辛伐他汀對內固定彊度的影響及其作用機製.方法 取3月齡雌性SD大鼠24隻,切除雙側卵巢製備大鼠骨質疏鬆模型.3箇月後將動物隨機分為三組.右側股骨髁植入鈦閤金螺釘後于髓腔內分彆註射5 mg、10 mg辛伐他汀或空白PBS緩遲液.術後1箇月行骨密度測定、螺釘週圍骨微結構定量分析,測定螺釘最大載荷,通過免疫組織化學染色觀察BMP-2的錶達.結果 辛伐他汀5 mg組、10 mg組骨密度分彆為(201±23.3)、(207.9±23.5) mg/cm2,與空白PBS緩遲液組(170.8±13.8) mg/cm2比較差異有統計學意義；螺釘骨整閤率分彆為51.4％±3.0％、52.6％±4.1％,較空白PBS緩遲液組(27.3％±4.9％)增加,螺釘週邊各項骨微結構指標均改善,差異有統計學意義；螺釘的最大載荷分彆為(161.5±9.4)、(161.9±11.4)N,高于空白PBS緩遲液組(145.7±9.6)N,差異有統計學意義；BMP-2的錶達較空白PBS緩遲液組增彊.結論 疏鬆骨骼跼部單次註射小劑量辛伐他汀可促進內植物週邊的骨整閤,增彊內固定的穩定性；其作用機製與跼部註射辛伐他汀促進BMP-2的高錶達有關.
목적 탐토소송골격국부주사신벌타정대내고정강도적영향급기작용궤제.방법 취3월령자성SD대서24지,절제쌍측란소제비대서골질소송모형.3개월후장동물수궤분위삼조.우측고골과식입태합금라정후우수강내분별주사5 mg、10 mg신벌타정혹공백PBS완충액.술후1개월행골밀도측정、라정주위골미결구정량분석,측정라정최대재하,통과면역조직화학염색관찰BMP-2적표체.결과 신벌타정5 mg조、10 mg조골밀도분별위(201±23.3)、(207.9±23.5) mg/cm2,여공백PBS완충액조(170.8±13.8) mg/cm2비교차이유통계학의의；라정골정합솔분별위51.4％±3.0％、52.6％±4.1％,교공백PBS완충액조(27.3％±4.9％)증가,라정주변각항골미결구지표균개선,차이유통계학의의；라정적최대재하분별위(161.5±9.4)、(161.9±11.4)N,고우공백PBS완충액조(145.7±9.6)N,차이유통계학의의；BMP-2적표체교공백PBS완충액조증강.결론 소송골격국부단차주사소제량신벌타정가촉진내식물주변적골정합,증강내고정적은정성；기작용궤제여국부주사신벌타정촉진BMP-2적고표체유관.
Objective To evaluate the effect of locally applied single dose of simvastatin in the femurs of osteoporotic rats on the initial stability of titanium screws inserted into distal femurs,and to explore the mechanism related to the effect.Methods Twenty-four female 3-month-old SD rats were ovariectomized (OVX) to induce osteoporosis.12 weeks later,the animals were randomly divided into three groups with 8 in each.After the titanium alloy screw was implanted into the right femoral condyle,simvastatin 5 mg,l0 mg and a blank PBS buffer were injected into the medullary cavity.Four weeks after the implantation combined with simvastatin or vehicle injection,femurs with implants were evaluated with dual-energy X-ray absorptiometry,micro-computed tomography,scanning electron microscopy,quantitative analysis of screw around bone microstructure was operated.Observe the bone tissue structure around the bolt by scanning electron microscopy and toluidine blue staining.Measure the maximum load by the screw press and observe the expression of BMP-2 by immunohistochemical staining.Results Compared with the control group,simvastatin doses of 5 and 10 mg caused a significant increase in BMD (201±23.3,207.9±23.5 vs.170.8±13.8 mg/cm2),and significantly improve osseointegration (51.4％±3.0％,52.6％±4.1％ vs.27.3％±4.9％),peri-implant microarchitecture,and thus leading to enhanced early mechanical fixation of titanium implants (161.5±9.4,161.9±11.4 vs.145.7±9.6 N) in the OVX rats.The osteointegration effect may result from the high expression of BMP-2.Conclusion This study showed that a single local injection of simvastatin in osteoporotic bone of OVX rats could promote osseointegration implant surrounding and enhance the stability of internal fixation.The mechanism of action is correlated to the high expression of BMP-2 promoted by local injection of simvastatin.
