骨形成蛋白-2在上颌骨快速牵引骨愈合中的作用  

Effect of bone morphogenetic protein-2 on bone healing in supramaxillary fast traction

作　　者：姚玉胜[1] 王程越[2] 王桂君[3] 

机构地区：[1]辽宁医学院附属第二医院口腔颌面外科,辽宁锦州121000 [2]辽宁省锦州市中心医院修复科,辽宁锦州121000 [3]辽宁医学院药学系,辽宁锦州121000

出　　处：《重庆医学》2013年第15期1692-1695,共4页Chongqing medicine

基　　金：辽宁省教育厅及辽宁医学院博士启动基金资助项目(L2010281)

摘　　要：目的探索上颌骨经缝牵引中(当弹性牵引力大于800g)加入重组人骨形成蛋白-2(rhBMP-2)对新骨形成的影响。方法将36只健康杂种犬随机分为5个组,即对照组、400g组、600g组、800g组及800g+rhBMP-2组(联合组)。术后1～8周处死动物,行X线检测及免疫组织化学染色检测。结果各牵引组上颌骨成功前徙,以600g组效果明显[(25.3±5.2)mm]。800g组在2周内牵引速度快,4周后明显减慢[(12.1±2.3)mm],但在注射rhBMP-2后得以改善[(24.2±3.4)mm]。BMP-2、BMP-4、BMP-7阳性染色主要定位于成骨细胞细胞质中,BMP-7在注射rhBMP-2后光密度值明显增强。CT检测各牵引组腭骨水平板骨密度值明显减低,以800g组最为显著[(317.8±185.5)HU],而在注射rhBMP-2后骨密度值明显增强[(1 158.0±93.0)HU]。结论骨缝牵引前移上颌骨能在微创早期延长骨长度;rhBMP-2可以有效促进骨形成并在调节rhBMP-7活性方面起到一定作用。Objective To investigate the effect of adding recombinant human bone morphogenetic protein-2 （rhBMP-2） on the bone regeneration in sutural supramaxillary distraction osteogenesis（elasticity traction force〉800 g）. Methods 36 healthy hybrid dogs were randomly divided into 5 groups,control,400 g, 600 g,800 g and 800 g＋rhBMP-2（combined） groups,and killed in post- operative 1-8 weeks for X-ray examination and immunohistology staining. Results Supramaxilla was successfully moved forward in the various traction groups,especially in the 600 g group（25.3±5.2）ram. The traction speed in the 800 g group was fast within 2 weeks and significantly slowed after 4 weeks（ 12.1±2.3）ram, which was improved after injection of rhBMP-2 [ （24.2± 3.4）mm]. Immunohistochemieal staining showed that the positive staining of BMP-2,BMP-4 and BMP-7 was evident in osteoblast plasma. Af- ter injection of rhBMP-2, the light density value in BMP-7 was obviously enhanced. The CT examinations showed that the bone den- sity values in jawbone horizontal plate was significantly decreased, especially in the 800 g group[ （317.8 ± 185.5）HU], but after in- jection of rhBMP-2 ,which was significantly enhanced[（1 158.0±93.0）HU]. Conclusion Sutural traction for advancing supramax- illa can extend the bone length at the early stage of microtrauma. RhBMP-2 may play certain role in the bone formation and the reg- ulation of the activity of BMP-7.

关 键 词：骨整合 牵引术 骨生成 重组人骨形成蛋白-2 

分 类 号：R782.2[医药卫生—口腔医学]