高能震波对骨质疏松骨的结构及力学性能影响  

Effects of high energy shock waves on the bone structure and mechanical strength in experimental osteoporosis

作　　者：李晓林[1] 马焕芝[1] 曾炳芳[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科

出　　处：《中国骨质疏松杂志》2009年第5期317-321,共5页Chinese Journal of Osteoporosis

摘　　要：目的探讨高能震波对骨质疏松骨的结构及力学性能影响。方法40只雌性新西兰兔去势,建立骨质疏松动物模型。应用高能震波处理一侧股骨近端,能量密度0.26 mJ/mm2,频率60次/min,冲击量为2000次;另一侧作为对照。分别于术后4、8、12、24周,行micro-CT、骨计量学及生物力学检测。结果micro-CT分析显示治疗组表观骨密度（Density of TV）、相对骨体积（BV/TV）、骨小梁厚度（Tb.Th）、骨小梁数目（Tb.N）均明显高于对照组,而骨表面积体积比（BS/BV）、骨小梁间隙（Tb.Sp）、骨小梁结构模型指数（SMI）较对照组少（P〈0.01）。骨组织形态计量学检测显示治疗组骨小梁体积和骨小梁厚度增加,骨小梁间距减少,骨矿化沉积率明显降低（P〈0.05）,骨小梁数目变化不明显（P〉0.05）。股骨粗隆最大压缩载荷治疗组为186.13±15.64,对照组为121.83±17.82,治疗组明显高于对照组（P〈0.05）。结论高能震波能促进骨质疏松骨形成,改善骨小梁的三维结构,增加骨质密度,改善力学性能,可被用来局部治疗骨质疏松及骨质疏松性骨折,预防再次骨折发生。Objective To investigate the influence of the high energy shock waves on the bone structure and mechanical strength in experimental osteoporosis. Methods Forty female New Zealand white rabbits were underwent ovariectomy （OVX） to establish the osteoportic models. Three months after OVX, the left limb （ the study side） received shock wave therapy（0.26 mJ/mm^2 energy flux density with 2000 impulses）to the proximal femur. The right limb （the control side） received no shock wave therapy. Biopsies of the the proximal femurs were performed and each of them was examined by by micro-CT, bone histomorphometry, biomeehanieal testing at 4, 8, 12 and 24 weeks after treatment. Results Microstructure of the trabecular bone in proximal femur 24 weeks after treatment showed that the Density of TV, BV/TV, Tb.Th, Tb. N at the study side increased significantly Compared with the control side, however the BS/BV, ＇lb. Sp, SMI and MAR decreased significantly （ P 〈 0.01 ）. In biomechanical testing, the maximum compressing strength of trabecular bone in the study side 24 weeks after treatment was higher than that in control side （P 〈 0.05 ）. Conclusion High energy shock wave treatment can accelerate the bone formation, increase the bone density, decreasing the rate of bone turnover and the good change of the microstructure, improve the bone quality and bone biomechanical strength, fracture in rats, and improves the mechanical strength. It maybe an alternative method to local treatment of osteoporosis and osteoporotic fractures chnically.

关 键 词：骨质疏松症 高能震波 MICRO-CT 骨计量学 生物力学 

分 类 号：R68[医药卫生—骨科学]