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目的探讨精氨酸-甘氨酸-天冬氨酸(Arg-Gly-Asp,RGD)多肽修饰的喷砂大颗粒酸蚀(sandblasted,large-grit and acid-etched,SLA)钛片对糖尿病小型猪骨结合的影响。方法本研究于2014年6月至2015年10月在南京军区总医院比较实验室进行。选取健康的广西巴马小型猪5只,用链脲佐菌素(STZ)随机诱导3只小型猪建立糖尿病模型,作为糖尿病组(diabetes model group,DM组);另2只正常饲养,作为非糖尿病组(non-diabetes model group,NDM组)。利用化学偶联法将RGD多肽接枝到SLA钛片上。每只小型猪上颌骨按预定方案植入6枚直径为5 mm的钛片,其中包含3枚SLA钛片(分别为DM-SLA组和NDM-SLA组)、3枚RGD多肽修饰的SLA钛片(分别为DM-RGD-SLA组和NDM-RGD-SLA组)。在植入钛片后1个月处死动物,取上颌骨,4%多聚甲醛固定。用Micro CT、硬组织切片以及SPSS21.0软件对实验结果进行分析。结果 Micro CT检测结果显示,在观察期内各组骨密度(BMD)、骨小梁厚度(Th.Th)、骨小梁数量(Th.N)和骨小梁间隙(Th.Sp)的差异均无统计学意义(均P>0.05)。硬组织切片分析显示,NDM-RGD-SLA组的钛片周围骨结合率(64.8%±18.4%)与DM-RGD-SLA组(33.9%±11.7%)、NDM-SLA组(39.5%±20.9%)和DM-SLA组(36.4%±15.9%)比较,差异均有统计学意义(均P<0.05);而其他各组两两比较,差异均无统计学意义(均P>0.05)。结论 (1)RGD多肽对SLA钛片周围骨结合有明显促进作用。(2)在实验的观察期内,动物是否患有糖尿病,对钛片与颌骨的骨结合无明显影响;当SLA钛片复合RGD多肽后,能明显促进非糖尿病动物的骨结合,但对糖尿病动物的骨结合作用不明显,提示糖尿病可能抑制了RGD多肽的促成骨作用。
Objective To investigate the effect of sandblasted, large-grit and acid-etched (SLA) modified with arginine-glycine-aspartate (RGD) The impact of the combination. Methods The study was conducted in the comparative laboratory of Nanjing Military Region General Hospital from June 2014 to October 2015. Five healthy Bama miniature pigs were selected, and three miniature pigs were randomly induced by streptozotocin (STZ) to establish diabetic model group as diabetes model group (DM group). The other two were kept as normal Diabetes group (NDM group). RGD peptides were chemically grafted onto SLA titanium plates. Each mini-pig’s maxillary bone was implanted with 6 titanium plates of 5 mm in diameter, including 3 SLA titanium plates (DM-SLA group and NDM-SLA group, respectively) and 3 RGD polypeptide-modified SLA titanium (DM-RGD-SLA group and NDM-RGD-SLA group, respectively). The animals were sacrificed one month after implantation of titanium and the maxilla was fixed with 4% paraformaldehyde. The experimental results were analyzed using Micro CT, hard tissue sections and SPSS21.0 software. Results Micro CT examination showed that the difference of BMD, Th.Th, Th.N and Th.Sp between the groups during the observation period No statistical significance (all P> 0.05). The histological sections of the NDM-RGD-SLA group showed that the rate of bone union (64.8% ± 18.4%) in the NDM-RGD-SLA group was significantly higher than that in the NDM-SLD group (33.9% ± 11.7% %) And DM-SLA group (36.4% ± 15.9%), the differences were statistically significant (all P <0.05). There was no significant difference between the other groups (P> 0.05). Conclusions (1) RGD polypeptide can promote the osteosynthesis around SLA titanium plate obviously. (2) Whether the animals had diabetes mellitus during the experimental observation period had no significant effect on the bone union of the titanium plate and the jaw bone. When the SLA titanium compound RGD polypeptide could obviously promote the osseointegration of non-diabetic animals, Osteoarthritis of diabetic animals is not obvious, suggesting that diabetes may inhibit the role of RGD polypeptide to promote bone.