脑外伤伴随骨折组织构建过程中生物活性因子的作用  

Role of humoral bioactive factors in fracture healing following traumatic brain injury

作　　者：刘辉[1] 禹宝庆[1] 胡海波[1] 

机构地区：[1]解放军第二军医大学长海医院骨科,上海市200433

出　　处：《中国组织工程研究与临床康复》2008年第33期6539-6545,共7页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:分析筛选脑外伤对骨折组织构建过程影响的体液生物活性因子。方法:检索中国期刊全文数据库、Pubmed数据库文献,然后对资料进行初审,并查看每篇文献后的引文。纳入标准:脑外伤后体液改变或体液因素影响骨折愈合过程;以近5年且发表在较权威杂志者优先。排除标准:重复研究文章。结果:①骨折具有加速愈合潜能,继发于创伤性脑损伤的骨折能够加速愈合。脑损伤、脊髓损伤、脊髓不同部位损伤、神经损伤时对骨折愈合影响不同。脑外伤后体液中存在促进骨髓基质干细胞有丝分裂和增殖的细胞因子。②骨形态发生蛋白是骨折成功愈合的极重要的因素,然而骨形态发生蛋白似乎并非是脑外伤后骨折愈合加速因素之一。③转化生长因子β既与颅脑损伤有关,也与骨折愈合有关,可能是脑损伤时促进骨折愈合的细胞因子之一。④脑外伤后碱性成纤维细胞生长因子阳性表达提前出现,与血管内皮细胞生长因子有明显的时间和浓度关系,通过血管内皮细胞生长因子、转化生长因子β的表达促进成骨。⑤血管内皮细胞生长因子只是创伤性脑损伤时多种生长因子网络中的一员,单一因子在体内的真实作用如何还有待于今后深入研究。⑥血清生长激素与胰岛素样生长因子之间相互作用促进骨折愈合机制有待进一步研究。⑦神经生长因子、催乳素、褪黑激素在脑损伤患者血清中浓度显著改变,可能是影响骨折愈合体液因素,其确切机制有待深入研究。结论:脑外伤后伴随的骨折愈合加速现象与全身、局部因素有关,目前关于各种体液因素的研究水平不同步。有些体液因素如骨形态发生蛋白、转化生长因子β、碱性成纤维细胞生长因子等)与骨折愈合的关系研究已开展得较为深入;另外更多的可能促进骨折愈合的体液因素还有待于筛选,进一步证实。AIM： To analyze and screen humoral bioactive factors associated with accelerated fracture healing after traumatic brain injury. METHODS： A computer-based online search of Chinese Journal Full-text Database and Pubmed database was undertaken to identify related articles. After the first trial, only articles about the effect of humor changes after brain trauma or humoral factors on fracture healing were selected, and those published in recent five years and published in a authoritative journal were preferred. Repetitive research was excluded. RESULTS： Fracture healing can be accelerated, especially for people with traumatic brain injury. Brain injury, spinal cord injury, different parts of the spinal cord injury, and nerve injury have different influences on fracture healing. There are cell active factors in humour of patients after traumatic brain injury, which can induce karyogenetic division and proliferation of bone marrow-derived stroma ceils. Bone morphogenetic protein （BMP） is a very important factor in fracture healing, but it seems not one of factors that are associated with accelerated healing mechanism. Transforming growth factor- β （TGF- β ） is correlated with brain injury and bone healing. It is likely to be one of cell factors that can promote fracture healing. Basic fibroblast growth factor （bFGF） has an early expression in traumatic brain injury patients, which can promote osteoblast by stimulating vascular endothelial growth factor （VEGF） and TGF- β expressions. VEGF is only a member of various factors in the network in fracture healing. The action mechanism of single factor needs further exploration. Growth hormone has a high concentration in patients with traumatic brain injury, and can promote fracture healing through interaction with insulin-like growth factor. However, the mechanism is still uncertain. Nerve growth factor, prolactin and melantonin concentration significantly change after traumatic brain injury. They may be the humoral factors that influence bone healin

关 键 词：活性因子 骨折愈合 脑外伤 体液因素 组织构建 

分 类 号：R318[医药卫生—生物医学工程]