摘要
目的：以隔膜技术为手段，进一步探讨骨折不愈合的原因。方法：成年雄性新西兰兔共４２只，在其双侧桡骨中段制作１０ｍｍ标准骨缺损不愈合模型，随机选择一侧为实验侧，另一侧用硅胶膜成管状包裹骨缺损为对照侧。Ａ组１２只动物术后进行Ｘ线观察；Ｂ组３０只动物随机分为６组，术后不同时期进行组织学以及骨形态发生蛋白（ＢＭＰ）、转化生长因子β（ＴＧＦ－β）、碱性成纤维细胞生长因子（ｂＦＧＦ）单克隆抗体的免疫组化染色和ｃＤＮＡ探针原位杂交观察。结果：（１）Ｘ线证实１２只动物在１２周时实验侧无一例愈合；而对照侧则有８例愈合。（２）组织学可见实验侧早期有软骨形成和软骨内成骨，只是在４周以后不再有软骨形成及软骨内成骨。（３）发现三种骨诱导因子在两组的表达并不存在质的不同，但其含量变化却有明显的差别，各个时间组实验侧含量均低于对照侧，特别是从第４周开始下降得最为明显（Ｐ＜０．０１）。结论：骨缺损不愈合是由于组织分化出现了异常，而骨诱导因子含量的下降是导致骨组织分化障碍的根本原因，最终使得骨缺损瘢痕连接。
Objective: To study the cause of nonunion of fracture by membrane technique. Methods: Forty two adult, male, New Zealand rabbits were used for this study. 10 mm standard bone defect model was produced bilaterally in the forelegs of each rabbit. Randomly, one defect served as experimental, and the another defect enveloped with silicon membrane as a control. Group A including 12 rabbits for X-ray examination weekly after procedure, Group B including 30 rabbits divided into 6 subgroups, which were sacrificed at different periods after surgery for histological observation, immunohistochemical staining of BMP, TGF-β , bFGF and in situ hybridization of their cDNA probes. Results: 1) X-ray showed that there was no union in experimental sides in 12 rabbits, while there were 8 healed in control sides at 12 weeks after surgery. 2) Cartilage formation and endochondral ossification were found in test sides at an earlier stage, which stopped after 4 weeks postoperatively. 3) Although expression of three osteoinductors was the same between the test and control sides, their content was different. The content in the test side was always much less than that in the control side, which declined mostly at 4 weeks after surgery ( P <0.01). Conclusion: The cause of bone defect nonunion was abnormal differentiation of bone tissue, which was resulted in reduction of osteoinductors.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1998年第11期678-681,I002,共5页
Chinese Journal of Orthopaedics
关键词
骨再生
隔膜技术
生长物质
骨折愈合
Bone regeneration Guided tissue regeneration Fractures,ununited Growth substances
