骨质疏松对大鼠胫骨骨折愈合质量的影响  

Osteoporosis impairs fracture healing of tibia in a rat osteoporotic model

作　　者：徐少文[1] 王建卫[1] 李伟[1] 王云[1] 赵光锋[1] 

机构地区：[1]浙江大学医学院第二医院骨科,杭州310009

出　　处：《中华医学杂志》2004年第14期1205-1209,共5页National Medical Journal of China

摘　　要：目的　探讨骨质疏松对大鼠骨折愈合质量的影响。方法　 84只 4月龄雌性SD大鼠随机分成去卵巢骨质疏松 (OP)组和假手术对照 (SO)组 ,两组各 4 2只。去势后 10周骨质疏松模型建立后 ,各大鼠建立胫骨骨折内固定模型。骨折后 2、4、6、12、18周取胫骨标本行骨组织形态学、骨矿物质密度 (BMD)、生物力学等检测 ,比较两组骨折愈合情况。结果　与SO组比较 :( 1)OP组骨折愈合过程中软骨内成骨过程延缓 ,骨小梁结构疏松、排列紊乱 ,可见大量破骨细胞 ;( 2 )骨折后 6、12、18周OP组骨痂BMD比SO组分别小 12 8%、18 0 %、17 0 % ,差异有显著意义 (均P <0 0 5 ) ;( 3)骨折后 4、6、12、18周OP组骨痂最大载荷比SO组分别小 2 4 3%、31 5 %、2 6 6 %、2 8 8% ;最大应力比SO组分别小 2 3 9%、33 6 %、19 1%、2 4 9% ,两指标在各时点差异均有显著意义 (均P <0 0 5 )。结论　骨质疏松影响大鼠胫骨骨折中晚期愈合质量 ,主要表现为软骨内成骨过程缓慢、破骨细胞骨吸收活跃。Objective To evaluate the influence of osteoporosis on fracture healing Methods Eighty four 4 months old female Sprague Dawley rats were randomly divided into osteoporosis(OP) group and sham operation(SO) group, 42 in each Rats in OP group were performed ovariectomy operation while those in SO group with sham operation When osteoporosis formed 10 weeks after ovariectomy, midshaft tibia fracture model was established Tibias were harvested 2 weeks (2 rats per group), 4 weeks (9 rats per group), 6 weeks (9 rats per group), 12 weeks (9 rats per group) and 18 weeks (7 rats per group) after fracture for bone mineral density(BMD), histomorphological and biomechanical evaluation Results Compared with the SO group: (1) Callus BMD was significantly lower about 12 8%, 18 0%, 17 0% in OP group 6, 12, 18 weeks after fracture, respectively ( P <0 05) (2) Callus failure load was significantly lower about 24 3%, 31 5%, 26 6%, 28 8% in OP group, and callus failure stress was also significantly lower about 23 9%, 33 6%, 19 1%, 24 9% in OP group 4, 6, 12, 18 weeks after fracture, respectively ( P <0 05) (3) In OP group, endochondral bone formation was delayed, more osteoclast cell could be seen around the trabecula, and the new bone trabecula arranged loosely and irregularly Conclusion Osteoporosis influences the middle and late periods of fracture healing in the rat osteoporostic model The impairment is considered to be the result of the combined effects of the prolonged endochondral calcification, high activated osteoclast cell and the deceleration of the increase in bone mineral density

关 键 词：骨质疏松 大鼠 胫骨骨折 生物力学 骨矿物质 

分 类 号：R58[医药卫生—内分泌]