摘要
目的应用骨形态计量学观察粗聚焦震波对大鼠骨质疏松性骨折愈合的影响,探讨其作用机制。方法将30只体重为(280±2.5)g的6月龄雌性清洁级SD大鼠双卵巢去势,复制骨质疏松模型后行双侧胫骨近端截骨并予克氏针内固定术。术后左侧胫骨用能量密度0.26mj/mm2,频率60次/min,脉冲2000次的高能震波治疗1次(治疗组),右侧胫骨不予震波治疗(对照组)。随后行组织学观察、骨组织不脱钙切片观察与测定。结果组织学观察结果显示,震波治疗后2周时治疗组与对照组相比炎性反应强,胶原形成相对多,成熟胶原多,形成的骨小梁较多;4周时治疗组成熟骨小梁较多,软骨性骨痂逐渐为骨性骨痂替代,大量类骨质形成。骨组织不脱钙切片观察与测定发现,震波治疗后8周治疗组大鼠骨体积分数(BV/TV)、骨小梁数(Tb.N)、骨小梁厚度(Tb.Th)、活跃成骨细胞表面(Ob.S/BS)、纠正骨矿化沉积率(jMAR)等参数均高于对照组,而骨小梁骨间距(Tb.S)、矿化延迟时间(Mlt)等指标低于对照组,差异均具有统计学意义。结论粗聚焦高能震波能促进骨质疏松性骨折后骨形成,改善骨形态,提高局部骨密度,达到防止骨量丢失的作用。同时可增加骨矿化沉积率,缩短矿化延迟时间,抑制骨转换,可能成为局部治疗和预防人体骨质疏松性骨折的新选择。
Objective To observe the change of bone histomorphometry,the effect and mechanism of high energy shock wave on osteoporotic fracture healing in rats. Methods 30 female SD rats aged 6 months weighted 280 ± 2. 5 g （ mean ± SE） were castrated of bilateral ovarian for estabolishmg osteoporosis model. After successful modeling,18 SD rats were treated by double proximal tibial osteotomy and Kirschner wire internal fixation after randomly selected. The rats were treated with unfocused high energy shock waves once by energy density of 0. 26 mj / mm^2 ,60 each minute of rate of recurrence and 2000 pact quantities to the left tibia. The contralateral,right tibia was not treated and served as a control. The rats of both groups were regularly observed with histological observation. Results It is shown,according to the histology,inflammatory reaction in the treatment group is stronger and its mature collagens as well as collagens and bone trabecula that is formed is more than that in control group. At four weeks,the number of mature bone trabeculas increases while cartilaginous calluses are gradually replaced by bony calluses and a lot of osteoid forms. At 8 weeks,bone tissue slice without decalcification showed that percent bone volume （ BV / TV） ,bone trabecular thickness （ Tb. Th） ,bone trabecular number （ Tb. N） ,and other static index,as well as the dynamics parameters such as： active osteoblast surface （ Ob. S/BS） ,adjusted apposition rate （ jMAR） in the treatment group were higher than those in the control group. Compared with the control group,trabecular separation and mineralization lag time （ Mlt ） were lower. Conclusion Unfocused high energy shockwave could promote bone formation after bone fractures,improve bone mass form and local bone mineral density to prevent bone loss; At the same time,it could increase mineral apposition rate and reduce mineralization lag time to inhibit bone remodelling,which may be a new options for local treatment and prevention of osteoporotic fracture.
出处
《中华骨质疏松和骨矿盐疾病杂志》
2013年第2期149-155,共7页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
国家自然科学基金(81071501)
上海市科委医学引导项目(09411966500)
关键词
骨形态计量学
粗聚焦震波
骨质疏松性骨折
骨折愈合
bone histomorphometry
unfocused high energy shock wave
osteoporotic fracture
fracture healing
