| 载骨形成蛋白2和肌肤生对兔胫骨慢性骨髓炎修复作用的实验研究 |
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投稿时间：2021-05-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 蓝益南 |
LAN Yi-nan |
浙江省丽水市中心医院骨科, 浙江 丽水 323000 |
Department of Orthopaedics Surgery, Lishui Central Hospital, Lishui 323000, Zhejiang, China |
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| 李健 |
LI Jian |
浙江省丽水市中心医院骨科, 浙江 丽水 323000 |
Department of Orthopaedics Surgery, Lishui Central Hospital, Lishui 323000, Zhejiang, China |
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| 蔡晓斌 |
CAI Xiao-bin |
浙江省丽水市中心医院骨科, 浙江 丽水 323000 |
Department of Orthopaedics Surgery, Lishui Central Hospital, Lishui 323000, Zhejiang, China |
caixiaobin1974@163.com |
| 吴凌峰 |
WU Ling-feng |
浙江省丽水市中心医院骨科, 浙江 丽水 323000 |
Department of Orthopaedics Surgery, Lishui Central Hospital, Lishui 323000, Zhejiang, China |
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| 张扬 |
ZHANG Yang |
浙江省中医药研究院, 浙江 杭州 320012 |
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| 吴件姿 |
WU Jian-zi |
浙江省丽水市中心医院骨科, 浙江 丽水 323000 |
Department of Orthopaedics Surgery, Lishui Central Hospital, Lishui 323000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第10期，第971-977页 |
| DOI：10.12200/j.issn.1003-0034.2021.10.016 |
| 基金项目:浙江省医药卫生科技计划项目（编号：2018KY186）；浙江省科技计划项目（编号：2017C37181） |
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中文摘要:
目的：探讨在骨髓炎兔的实验模型中，载骨形成蛋白2联合肌肤生一期治疗的效果评价。
方法：选取3月龄雄性新西兰大白兔30只，体重（2.0±0.5）kg，制备兔胫骨慢性骨髓炎模型，并于术后4周进行模型验证。将30只兔慢性骨髓炎随机分为3组，每组10只。模型组于病灶清除后不做任何处理；治疗组A于病灶清除及骨缺损处植入肌肤生；治疗组B于病灶清除及骨缺损处植入载骨形成蛋白2-肌肤生。术后8周通过血液生化、微生物、影像学、病理学及免疫组化等检查进行治疗作用评价。
结果：造模术后4周，30只骨髓炎兔模型验证成功，其中血清学检查结果显示，造模术后2周及4周模型组的超敏C反应蛋白显著高于空白组（P<0.01、P<0.05），白细胞计数显著高于空白组（P<0.05、P<0.01）。治疗术后8周，血液指标检测，治疗A组与治疗B组的白细胞计数、超敏C反应蛋白显著低于模型组（P<0.05），但治疗A与治疗B组差异无统计学意义。治疗术后8周，骨缺损面积测量，治疗A组与治疗B组的骨体积/总体积（BV/TV）及骨矿化密度大于模型组（P<0.05），且治疗B组的骨体积/总体积（BV/TV）及骨矿化密度大于治疗A组（P<0.05），骨缺损修复接近完全，骨体积与骨密度显著升高。治疗术后8周，骨组织病理学检测，治疗A组与治疗B组的HE染色指标成骨细胞数/骨组织面积（N.Ob/T.Ar）、成骨细胞数/骨组织周长（N.Ob/B.Pm）高于模型组（P<0.05），且治疗B组的N.Ob/T.Ar和N.Ob/B.Pm大于治疗A组（P<0.05）；治疗A组与治疗B组的骨组织周围TNF-α和IL-6免疫组化阳性染色率少于模型组（P<0.05），但治疗组B与治疗组A差异无统计学意义。
结论：载骨形成蛋白2-肌肤生联合应用能共同促进骨修复，并减轻病灶部位炎症，可以一期治疗兔慢性骨髓炎，为骨髓炎临床治疗策略制订提供客观依据，进一步促进临床研究。 |
| 【关键词】肌肤生 载骨形成蛋白2 骨髓炎 兔 骨修复 |
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| Efficacy of apolipoprotein 2-Jifusheng in the treatment of osteomyelitis in rabbits |
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ABSTRACT
Objective: To evaluate the effect of one-stage treatment of bone morphogenetic protein 2 combined with Jifusheng in the experimental model of osteomyelitis in rabbits.
Methods: The model of chronic osteomyelitis of tibia was established in 30 3-month-old male New Zealand white rabbits with a body weight of (2.0±0.5) kg,and the model was verified 4 weeks after operation. Thirty rabbits with osteomyelitis were randomly divided into 3 groups with 10 rabbits in each group (n=10). The model group did not do any treatment after focal debridement,treatment group A was implanted with musculosheng at the site of focal debridement and bone defect,and treatment group B was implanted with apolipoprotein 2-Jifusheng at the site of focal debridement and bone defect. The therapeutic effect was evaluated by blood biochemical,microbiological,imaging,pathological and immunohistochemical examination 8 weeks after operation.
Results: At 4 weeks after operation,30 rabbits with osteomyelitis were successfully validated. The results of serological examination showed that the hypersensitive C-reactive protein (CRP) and white blood cell count(WBC)in the model group were significantly higher than those in the blank group at 2 and 4 weeks after operation. Eight weeks after treatment,the detection of blood indexes showed that the white blood cell count(WBC)and hypersensitive C-reactive protein(CRP)in treatment group A and treatment group B were significantly lower than those in the model group(P<0.05),but there was no significant difference between treatment group An and treatment group B(P>0.05). Eight weeks after treatment,the bone defect area was measured. The bone volume/total volume(BV/TV) and bone mineral density(BMD)in treatment group A and B were significantly higher than those in the model group(P<0.05),and the bone volume/total volume (BV/TV) and bone mineral density(BMD)in treatment group B were significantly higher than those in treatment group A (P<0.05),the repair of bone defect was almost complete,and the bone volume and bone mineral density increased significantly. At 8 weeks after treatment,the number of osteoblasts/bone tissue area(N.Ob/T.Ar) and the number of osteoblasts/bone tissue perimeter (N.Ob/B.Pm) in treatment group A and B were significantly higher than those in model group,and the N.Ob/T.Ar and N.Ob/B.Pm in treatment group B were significantly higher than those in treatment group A. The immunohistochemical staining of TNF-α and IL-6 around bone tissue in treatment group A and treatment group B was significantly less than that in model group,but there was no significant difference between treatment group B and treatment group A.
Conclusion: The combined application of apolipoprotein 2-Jifusheng can promote bone repair and reduce the inflammation of the focus. it can treat rabbits with osteomyelitis in one stage,provide objective basis for the formulation of clinical treatment strategy of osteomyelitis and further promote clinical research. |
| KEY WORDS Jifusheng Bone morphogenetic protein 2 Osteomyelitis Rabbits Bone repair |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 蓝益南,李健,蔡晓斌,吴凌峰,张扬,吴件姿.载骨形成蛋白2和肌肤生对兔胫骨慢性骨髓炎修复作用的实验研究[J].中国骨伤,2021,34(10):971~977 |
| 英文格式: | LAN Yi-nan,LI Jian,CAI Xiao-bin,WU Ling-feng,ZHANG Yang,WU Jian-zi.Efficacy of apolipoprotein 2-Jifusheng in the treatment of osteomyelitis in rabbits[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(10):971~977 |
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