摘要
目的探究体外冲击波(ESW)联合富血小板血浆(PRP)对骨质疏松骨折大鼠骨愈合的影响。方法采用卵巢摘除术(OVX)构建骨质疏松大鼠模型,将50只雌性3月龄SD大鼠随机均分为对照组(Control)、OVX组、OVX+ESW组、OVX+PRP组和OVX+ESW+PRP组,Control组切除等量卵巢周围组织;上述组别大鼠均造成右侧股骨骨折,并用克氏针髓内固定,观察ESW联合PRP对骨质疏松骨折大鼠骨愈合的影响,并探讨其作用机制。结果OVX术后大鼠骨密度为(0.22±0.07)g/cm^2,显著低于Control组(P<0.05)。影像学显示,OVX+ESW+PRP组骨折线清晰,有大量骨痂组织形成,骨折愈合程度优于OVX+ESW组、OVX+PRP组。HE染色显示,治疗后OVX+ESW+PRP组骨小梁变粗、数量增多,排列比较有序,组织病理改善效果优于OVX+ESW组、OVX+PRP组。ESW联合PRP治疗OVX大鼠后,大鼠骨折处最大负荷、骨痂组织中骨形态发生蛋白-2(BPM-2)、成骨分化关键转录调控因子2(RUNX2)及锌指结构转录因子(OSX)蛋白的表达升高,血清骨碱性磷酸酶(BALP)、骨钙素(BGP)及Ⅰ型前胶原羧基端肽(PICP)水平降低(P<0.05),效果优于OVX+ESW组、OVX+PRP组。结论ESW联合PRP可促进骨质疏松骨折大鼠骨愈合,可能与下调BALP、BGP及PICP水平,上调BPM-2、RUNX2及OSX的表达有关。
Objective To explore effects of extracorporeal shock wave(ESW)combined with platelet rich plasma(PRP)on bone healing in rats with osteoporotic fracture.Methods Osteoporosis rat models were established by ovariosteresis(OVX).50 female 3 months old SD rats were randomly divided into control group(Control),OVX group,OVX+ESW group,OVX+PRP group and OVX+ESW+PRP group,10 cases in each group.In Control group,the same amount of ovarian surrounding tissue was excised.The right femur fracture was conducted on rats in the above groups,and the rats were given intramedullary fixation with Kirschner wire.The effects of ESW combined with PRP on bone healing in rats with osteoporotic fracture were observed.And the action mechanism was explored.Results After OVX,bone mineral density of rats was(0.22±0.07)g/cm^2 and significantly lower than that in Control group(P<0.05).Imaging showed that fracture line was clear in OVX+ESW+PRP group,there were large number of bone callus tissues formation,and fracture healing was better than that in OVX+ESW group and OVX+PRP group.HE staining showed that after treatment,bone trabecula was thicker and its number got more in OVX+ESW+PRP group.And arrangement was orderly,histopathological improvement was better than that in OVX+ESW group and the OVX+PRP group.After OVX rats were treated with ESW and PRP,in maximum load at fracture site,the expression of bone morphogenetic protein-2(BPM-2),runt-related transcription factor 2(RUNX2)and zinc finger transcription factor(OSX)in bone callus tissue increased,while the levels of serum bone alkaline phosphatase(BALP),bone gla protein(BGP)and procollagen typeⅠcarboxy-terminal peptide(PICP)decreased(P<0.05).And the effect was better than that in OVX+ESW group and OVX+PRP group.Conclusion ESW combined with PRP can promote bone healing in rats with osteoporotic fracture,which may be related to down-regulation of BALP,BGP and PICP levels,and up-regulation of BPM-2,RUNX2 and OSX expression.
作者
张卫华
陈东
Zhang Weihua;Chen Dong(The First Dept of Orthopedics,Hanyang Hospital of Wuhan,Wuhan 430050)
出处
《安徽医科大学学报》
CAS
北大核心
2020年第3期422-427,共6页
Acta Universitatis Medicinalis Anhui
基金
湖北省卫生健康委员会2019~2020年度面上项目和血防专项(编号:WJ2019M038)。
关键词
体外冲击波
富血小板血浆
骨质疏松
骨愈合
extracorporeal shock wave
plateletrich plasma
osteoporosis
bone healing
