骨组织局部单位体积内生物电能低下与应力遮挡综合症  

Low bio-energy in per unit volume of bone tissue is due to stress shielding syndrome

作　　者：商振德[1] 

机构地区：[1]中国人民解放军464医院骨科,天津300381

出　　处：《生物骨科材料与临床研究》2013年第2期1-4,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨"组织细胞生物电能稳态失衡"概念与骨折内固定后出现应力遮挡综合症发生发展的关系。方法引入一个新的概念,即"组织细胞内环境生物电能稳态"(或"骨组织内单位体积生物电能含量稳态")。这个概念包括骨组织细胞外基质中蛋白聚糖分子生物电能的储存量、细胞膜膜电位以及细胞内负离子含量要维持在一个正常范围。通过这一新理论阐述应力遮挡形成原因的关系。结果骨折内固定(钢板或带锁髓内钉)出现不同程度的应力遮挡现象,应力遮挡区域骨组织出现单位体积内生物电能含量不足,并且处于长期、持续性生物电能含量减低现象,导致内固定应力遮挡范围内骨组织生物电能稳态失衡,骨组织处于长期、持续性极其轻度的酸化环境中,最终出现骨组织局部骨质疏松。结论骨组织单位体积内生物电能含量持续性减低是导致骨质疏松、骨愈合缓慢(应力遮挡)的原因。Objective To investigate the relationship between biological energy homeostasis of tissue and cell and stress shielding syndrome after fracture internal fixation. Method To introduct a new concept, named ＂the tissue cells environment bio-energy steady state＂ （or ＂No-energy steady state in the unit volume of hone tissue＂）. This concept includes the amount of biological energy storage in the bone tissue extracellular matrix proteoglycan molecules, membrane poten- tial and intracellular anion content which is to be maintained in a normal range. Through this new theory, the causes of stress shielding is revealed. Results Fracture internal fixation （steel plate or interlocking intramedullary nail） appears in varying degrees of stress shielding phenomenon. Per unit volume of bone tissue in stress shielding region appears insufficient bio-energy content. In the long-term, persistent bio-energy content reduction results in the b^ne tissue acidi- fication and eventually local osteoporosis. Conclusion The biological energy content reduction in per unit volume of bone tissue is due to osteoporosis and slow healing of the bone （stress shielding）.

关 键 词：内环境稳态 细胞膜电容放电 生物电能 蛋白聚糖及胶原纤维 骨折 应力遮挡 

分 类 号：R329[医药卫生—人体解剖和组织胚胎学]