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山东大学学报(医学版) ›› 2015, Vol. 53 ›› Issue (2): 22-26.doi: 10.6040/j.issn.1671-7554.0.2014.732

• 基础医学 • 上一篇    下一篇

机械应力作用下促进骨不连愈合的疗效

李尚志, 刘海春, 武文亮, 曹聪, 陈允震   

  1. 山东大学齐鲁医院骨外一科, 山东 济南 250012
  • 收稿日期:2014-10-22 出版日期:2015-02-10 发布日期:2015-02-10
  • 通讯作者: 陈允震. E-mail:qilucyz@yeah.net E-mail:qilucyz@yeah.net
  • 基金资助:
    山东省科技攻关计划(2008GG10002057)

Curative effect of mechanical stress in the treatment of nonunion

LI Shangzhi, LIU Haichun, WU Wenliang, CAO Cong, CHEN Yunzhen   

  1. Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2014-10-22 Online:2015-02-10 Published:2015-02-10

摘要: 目的 观察机械应力作用下促进大鼠骨不连愈合的效果,为机械应力促进骨不连断端骨折愈合提供分子水平的理论依据.方法 选取6月龄雌性SD大鼠,采用自制的可调式外固定架建造大鼠骨不连模型,并通过骨不连断端影像学评分,确定骨不连模型的建立.待模型建成后,随机分为实验组和对照组,每组30只,其中实验组骨折断端加压,对照组骨折断端不作处理,进一步对断端影像学和组织学钙钴法染色、成骨因子(BMP、VEGF)扩增检测.结果 实验组加压12周后,影像学评分较同组4、8周及对照组差异有统计学意义(P<0.05).钙钴法显示,在不同时间点实验组骨不连断端成骨细胞数量明显增多,与对照组相比差异有统计学意义(P<0.05).实验组BMP、VEGF在不同时期的基因扩增明显高于对照组(P<0.05).结论 机械应力能有效促进骨不连断端成骨细胞数量的增多及成骨因子的扩增,并有效促进骨不连断端的愈合.

关键词: 骨折, 大鼠模型, 骨不连, 机械应力, 成骨因子

Abstract: Objective To observe the therapeutic effects of mechanical stress in treating nonunion in animal models. Methods Animal models of nonunion were built using self-adjustable external fixation. The models were then randomly divided into the experimental group and control group, with 30 animals in either group. The experimental group received axial pressure on the fracture end, while the control group received no pressure. Then nonunion was imaged and stained, and osteogenetic factors such as bone morphogenetic protein (BMP) and vascular endothelial growth factor (VEGF) were detected. Results There were statistical differences between the experimental group and control group (P<0.05). Calcium cobalt staining revealed that more osteoblasts were generated, and more amplification of BMP and VEGF were observed in the experimental group at different time points (both P<0.05). Conclusion Mechanical stress can promote the growth of osteoblasts and amplification of osteogenetic factors in the nonunion, and effectively accelerate its healing.

Key words: Mechanical stress, Rat model, Fracture, Nonunion, Osteogenetic factors

中图分类号: 

  • R687.1
[1] Borrelli J Jr, Prickett WD, Ricci WM. Treatment of non-unions and osseous defects with bone graft and calcium sulfate[J]. Clin Orthop Relat Res, 2003, Jun:(411):245-254.
[2] Cypher TJ, Grossman JP. Biological principles of bone graft healing[J]. J Foot Ankle Surg, 1996, 35(5):413-417.
[3] Murnaghan M, Li G, Marsh DR. Nonsteroidal Antiinflammatory drug-induced fracture nonunion: an inhibition of angiogenesis[J]. J Bone Joint Surg Am, 2006, 88(Suppl 3):140-147.
[4] Thiel M. Application of shock waves in medicine[J]. Clin Orthop, 2007, 387:18-21.
[5] Chen YJ, Warts T, Wang CJ, et al. Recruitment of mesenchymal stem cells and expression of TGF-beta 1 and VEGF in the early stage of shock wave-promoted bone regeneration of segmental defect in rats[J]. J Orthop Res, 2006 , 22(3):526-534.
[6] Kido S, Kuriwaka KR, Imamura T, et al. Mechanical stress induces interleukin-1 expression to stimulate osteoblast differentiation[J]. Bone, 2009, 45(6):1125-1132.
[7] Mavcic B, Antolic V. Optimal mechanical environment of the healing bone fracture/osteotomy[J]. Int Orthop, 2012, 36(4):689-695.
[8] 田林强, 郭风劲, 虞姬哲, 等. 动态压应力促进大鼠成骨细胞成熟分化的基因水平研究[J]. 中华物理医学与康复杂志, 2012, 34(3):181. TIAN linqiang, GUO Fengjin, YU jizhe, et al. A genetic study of dynamic compressive stress promoting proliferation and differentiation of rat osteoblasts[J]. Chin J Phys Med Rehabil, 2012, 34(3):181.
[9] Rentz JA, Chapman B, Alvarez PJ,et al. Stimulation of hybrid poplar growth in petroleum-contaminated soils through oxygen addition and soil nutrient amendments[J]. Int J Phytoremediation, 2003, 5(1):57-72.
[10] Lin H, Aubin CE, Parent S, et al. Recent advances in mechanobiological modeling of bone regeneration[J]. Mechanics Research Communications, 2012, 42:22-31.
[11] Moutsatsos IK, Turgeman G, Zhou S, et al. Exogenously regulated stem cell-mediated gene therapy for bone regeneration[J]. Mol Ther, 2001, 3(4):449-461.
[12] Langenfeld EM, Langenfeld J. Bone morphogenetic protein-2 stimulates angiogenesis in developing tumors[J]. Mol Cancer Res, 2004, 2(3):141-149.
[13] Deckers MM, Vail Bezooijen RL, van der Horst G, et al. Bone morphogenetic proteins stimulate angiogenesis through osteoblast-derived vascular endothelial growth factor A[J]. Endocrinology, 2002, 143(4):1545-1553.
[14] Barron MJ, Tsai CJ, Donahue SW. Mechanical stimulation mediates gene expression in MC3T3 osteoblastic cells differently in 2D and 3D environments[J]. J Biomech Eng, 2010, 132(4):041005. doi: 10.1115/1.4001162.
[15] Groothuis A, Duda GN, Wilson CJ, et al. Mechanical stimulation of the pro-angiogenic capacity of human fracture haematoma: involvement of VEGF mechano-regulation[J]. Bone, 2010, 47(2):438-444.
[16] Foo T, Reagan J, Watson JT, et al. External fixation of femoral defects in athymic rats: Applications for human stem cell implantation and bone regeneration[J]. Journal of tissue engineering, 2013, 4: 2041731413486368.doi:10.1177/2041731413486368, Print 2013.
[17] Seamon J, Wang X, Cui F, et al. Adenoviral delivery of the VEGF and BMP-6 genes to rat mesenchymal stem cells potentiates osteogenesis[J]. Bone Marrow Res, 2013; 2013:737580. doi:10.1155/2013/737580.
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