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目的 :观察牵张成骨术矫治腭裂新骨形成的X线影像学特征 ,骨形成蛋白 (BMP)的表达与分布。方法 :以家猫 14只为实验对象 ,其中 12只建立人工腭裂实验模型。实验组 (10只 ) :造裂手术同时安置口内腭裂牵张装置。 4周后 ,二期手术形成骨运送盘 ,术后第 6日起 ,以每次 0 4mm ,每日两次的频率和恒定方向进行牵张 ,至腭部软硬组织裂隙封闭。固定期第 2、4、6、8及 12周安乐处死动物各 2只 ,切取标本行X线摄片及以Anti_BMP单抗免疫组化方法染色观察 ;另 2只动物为实验对照组。结果 :免疫组化结果显示 ,术后BMP广泛于牵开间隙的成骨细胞内表达 ,至术后 4～ 6周成骨活跃 ,骨连续性恢复。 8周及 12周组BMP表达渐趋减弱。X线影像亦显示新骨组织的钙化成熟是沿牵张方向由两侧向中央区域逐渐发展 ,二者具有时相相关性。实验对照组未见修复影像。结论 :牵张成骨过程经历了一个由无到有 ,由弱变强至整复骨缺损 ,而后趋于减弱至相对静止的动态变化规律。X线影像学研究手段亦证明 ,牵张间隙有规律地为新骨组织完全修复 ,最终恢复骨连续性且结构正常。
OBJECTIVE: To observe the X-ray imaging characteristics and bone morphogenetic protein (BMP) expression and distribution of distraction osteogenesis in the treatment of new bone formation of cleft palate. Methods: 14 domestic cats were used as experimental subjects, of which 12 were established artificial cleft palate experimental model. Experimental group (10): fracture surgery while placing mouth cleft palate distraction device. Four weeks later, the second operation formed a bone delivery tray. From the 6th day after the operation, it was stretched at a frequency of 0 4mm and twice daily at a constant direction until the soft and hard tissue fissures in the palate were closed. 2, 4, 6, 8 and 12 weeks of stationary phase were sacrificed in each of the two animals. The specimens were examined by X-ray and immunohistochemistry with anti-BMP monoclonal antibody. The other two animals were experimental control group. Results: Immunohistochemical results showed that postoperative BMP was widely expressed in osteoblasts with gap-opening, and reached active osteoclasts 4 to 6 weeks after operation. The bone continuity recovered. BMP expression gradually weakened at 8 weeks and 12 weeks. X-ray images also showed that the calcification of new bone tissue maturation along the stretch direction from two sides to the central region of the gradual development of the two have a time-dependent. Experimental control group no repair image. Conclusion: The process of distraction osteogenesis underwent a dynamic change from scratch, from weak to full bone defect, and then to weaken to relatively still. X-ray imaging studies have also proven that the distraction gap regularly regains the integrity of the new bone tissue, eventually restoring the bone continuity and the structure is normal.