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目的:观察以纤维蛋白为载体的骨形态发生蛋白-7(BMP-7)对骨质疏松性椎体骨折愈合的影响,探讨局部应用BMP-7纤维蛋白复合物治疗骨质疏松性椎体骨折的可行性。方法:雌性SPF级8月龄SD大鼠54只,随机选取36只,经去除卵巢建立骨质疏松模型并随机分为A、B组,每组18只;另18只行伪手术,在背部卵巢周围切除等体积脂肪,作为对照组(C组)。术后3个月所有动物采用L5椎体手术开窗刮除术区内松质骨方法建立骨折模型,A组骨折区内放入含BMP-724μg和纤维蛋白20mg的凝胶状混合物,B组和C组于同部位放入等体积小牛血清,盖好窗口骨瓣。建立骨折模型后4、6、8周,每组处死动物3只,取L5椎体切片行HE染色;6、8、12周时每组处死动物3只,行L5椎体力学性能测试(载荷能力、弹性模量和最大应变量)。结果:骨折后4周3组骨折区均有纤维骨痂形成,但B组纤维骨痂量少于A、C组;6周时A、C组有较多骨性骨痂形成,B组仅有微量骨性骨痂;8周时A、C组均为成熟小梁骨,骨折基本愈合,B组骨性骨痂量少,仍以纤维骨痂为主,尚有部分骨缺损存在;各时间点A组与C组相似。骨折后6、8、12周A、C组L5椎体的最大载荷、弹性模量及8、12周时的最大应变量均明显高于B组(P<0.05或0.01),B组6周时的最大应变量与A、C组比较无显著性差异(P>0.05),各时间点A组与C组比较无显著性差异(P>0.05)。结论:局部应用以纤维蛋白为载体的BMP-7能明显促进大鼠骨质疏松性椎体骨折的愈合,纤维蛋白可作为BMP-7的载体。
OBJECTIVE: To observe the effect of BMP-7 on the healing of osteoporotic vertebral fractures and to investigate the effect of topical application of BMP-7 fibrin composite on osteoporotic vertebral fractures Feasibility. Methods: Fifty-four female Sprague-Dawley (SD) rats of 8-month-old were randomly divided into three groups. Group A and group B were randomly divided into group A and group B, 18 in each group. The other 18 were sham-operated, Ovarian resection of equal volume of fat, as a control group (C group). At 3 months after operation, all the animals underwent L5 vertebrical surgery to create the fracture model by removing the cancellous bone in the operation area. Group A was given a gel-like mixture containing BMP-724μg and fibrin 20mg in group B, And C group in the same place into an equal volume of bovine serum, cover the window flap. At 4, 6 and 8 weeks after the establishment of the fracture model, 3 animals were sacrificed in each group, and HE staining was performed on the L5 vertebral sections. At 6, 8 and 12 weeks, 3 animals were sacrificed in each group. The L5 vertebral body mechanical properties test Ability, elastic modulus and maximum strain). Results: At 4 weeks after fracture, there were fibrous callus formation in all the three fracture zones, but the amount of fibrous callus in group B was less than that in group A and C. At 6 weeks, there were more bony callus formation in group A and C, while in group B only There was slight amount of bony callus. At 8 weeks, both A and C groups were mature trabecular bone, the fracture basically healed, the amount of bony callus was less in group B, the fiber callus was still the main part, and some bone defects still existed. Group A was similar to group C at time point. At 6, 8 and 12 weeks after fracture, the maximum load and elastic modulus of L5 vertebra in groups A and C and the maximum strain at 8 and 12 weeks were significantly higher than those in group B (P <0.05 or 0.01) (P> 0.05). There was no significant difference between group A and group C at each time point (P> 0.05). CONCLUSION: Topical application of fibrin-loaded BMP-7 can significantly promote the healing of osteoporotic vertebral fractures in rats. Fibrin can be used as a carrier of BMP-7.