CAJ | 학술논문

背景：合并下肢骨折颅脑损伤患者的骨折手术时机仍存在争论，颅脑损伤后早期骨折加速愈合的机制有待进一步阐明。目前颅脑损伤合并股骨闭合性骨折动物模型的制备报道较少，需建立稳定的动物模型以供临床研究。 　　目的：制备稳定的颅脑损伤合并股骨闭合性骨折大鼠模型，观察颅脑损伤后大鼠股骨骨折愈合过程中骨痂降钙素基因相关肽和胰岛素样生长因子1的表达，分析脑损伤对大鼠股骨骨折愈合速度的影响机制。 　　方法：48只雄性Sprague-Dawley大鼠随机分成2组，分别制备颅脑损伤合并股骨骨折模型及单纯股骨骨折模型，每组24只。分别于造模后7，14，28 d分批处死大鼠，截取骨折端长10 mm左右股骨骨痂标本，应用苏木精-伊红染色及免疫组化法，观察降钙素基因相关肽和胰岛素样生长因子1表达的动态变化。 　　结果与结论：免疫组化法测定两组大鼠骨折位点骨痂中降钙素基因相关肽阳性表达吸光度(A)值及胰岛素样生长因子1阳性细胞百分率，结果显示，颅脑损伤合并骨折组在7，14 d与单纯骨折组比较差异有显著性意义(P<0.05)；造模后28 d两组比较差异无显著性意义(P>0.05)；颅脑损伤合并骨折组的组内比较差异有显著性意义(P <0.05)；单纯骨折组的组内比较差异无显著性意义(P >0.05)。提示骨折端降钙素基因相关肽、胰岛素样生长因子1在脑损伤后合并股骨骨折模型大鼠骨折愈合的早中期表达增高，有利于多种细胞趋化、增殖与分化，促进成骨。在骨折愈合过程中降钙素基因相关肽和胰岛素样生长因子1可能是脑损伤后促进骨折愈合的影响因素。
배경：합병하지골절로뇌손상환자적골절수술시궤잉존재쟁론，로뇌손상후조기골절가속유합적궤제유대진일보천명。목전로뇌손상합병고골폐합성골절동물모형적제비보도교소，수건립은정적동물모형이공림상연구。 　　목적：제비은정적로뇌손상합병고골폐합성골절대서모형，관찰로뇌손상후대서고골골절유합과정중골가강개소기인상관태화이도소양생장인자1적표체，분석뇌손상대대서고골골절유합속도적영향궤제。 　　방법：48지웅성Sprague-Dawley대서수궤분성2조，분별제비로뇌손상합병고골골절모형급단순고골골절모형，매조24지。분별우조모후7，14，28 d분비처사대서，절취골절단장10 mm좌우고골골가표본，응용소목정-이홍염색급면역조화법，관찰강개소기인상관태화이도소양생장인자1표체적동태변화。 　　결과여결론：면역조화법측정량조대서골절위점골가중강개소기인상관태양성표체흡광도(A)치급이도소양생장인자1양성세포백분솔，결과현시，로뇌손상합병골절조재7，14 d여단순골절조비교차이유현저성의의(P<0.05)；조모후28 d량조비교차이무현저성의의(P>0.05)；로뇌손상합병골절조적조내비교차이유현저성의의(P <0.05)；단순골절조적조내비교차이무현저성의의(P >0.05)。제시골절단강개소기인상관태、이도소양생장인자1재뇌손상후합병고골골절모형대서골절유합적조중기표체증고，유리우다충세포추화、증식여분화，촉진성골。재골절유합과정중강개소기인상관태화이도소양생장인자1가능시뇌손상후촉진골절유합적영향인소。
BACKGROUND:The operation time for patients with craniocerebral injury with the lower limb fracture is not conclusive, and the mechanisms associated with the early healing of the fractures after traumatic brain injury remains to be clarified. At present, there are few animals models of brain injury combined with femoral closure fracture, and therefore, a stable animal model is needed for clinical studies. OBJECTIVE:To establish stable rat models of brain injury combined with femoral closure fracture, to investigate the expression of calcitonin gene-related peptide and insulin-like growth factor 1 in bone cal us during the healing process of femoral fracture, and to analyze the mechanism of brain injury on fracture healing. METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into two groups, in which the models of brain injury combined with femoral fracture and models of femoral fracture were established, respectively. Each group contained 24 rats. Rats were kil ed at 7, 14, 28 days after injury, a 10 mm femoral cal us around the fracture site was cut. The femoral cal us specimens were detected with hematoxylin-eosin staining and immunohistochemistry method. The dynamic changes of calcitonin gene-related peptide and insulin-like growth factor 1 expression were observed. RESULTS AND CONCLUSION:The immunohistochemistry results showed that, the absorbance of calcitonin gene-related peptide positive expression and the percentage of insulin-like growth factor 1 positive cel s in bone cal us of rats with brain injury and femoral fracture showed significant differences compared with the femoral fracture group at 7 and 14 days (P<0.05). The difference was not significant between the two groups at 28 days. The intragroup comparison results found significant difference in the brain injury and femoral fracture group (P<0.05), and no significant difference in the femoral fracture group (P>0.05). The expression of calcitonin gene-related peptide and insulin-like growth factor 1 was increased at the early and middle stages of fracture healing in rats with brain injury and femoral fracture, which contributes to the proliferation and differentiation of various cel s, as wel as promoting osteogenesis. Calcitonin gene-related peptide and insulin-like growth factor 1 are the possible factors promoting fracture healing.