骨折合并脑损伤对骨愈合和骨代谢的影响  

Dynamical effect of fractures combined with brain injury on the bone healing and bone metabolism

作　　者：周青[1] 刘进炼[1] 刘超群[1] 周耀东[1] 陈豪[1] 

机构地区：[1]上海交通大学医学院附属苏州九龙医院骨科,江苏省苏州市215021

出　　处：《中国组织工程研究》2015年第37期5911-5915,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:骨折周围神经损伤能够有效抑制破骨细胞活动,促进骨折早期愈合。目的:观察了大鼠肢体骨折合并脑损伤对骨密度、骨微结构、骨生物力学特征和骨代谢影响。方法:63只大鼠随机分为假手术组、单纯骨折组和脑损伤合并骨折组。在术后3周、6周和3个月分批麻醉处死动物保存骨骼和血清标本,检测骨密度、骨微结构和生物力学性能以及血清Ⅰ型胶原氨基末端肽和骨钙素水平的变化。结果与结论:与单纯骨折组相比,在造模3周和6周后,脑损伤合并骨折组胫骨近端的骨密度、松质骨微结构骨体积分数、骨小梁厚度、胫骨皮质骨截面总面积和骨髓腔面积、胫骨极限载荷和极限应力、血清原氨基末端肽和骨钙素水平均显著增高(P<0.05),造模后3个月,3组间上述指标均差异无显著性意义。结果证实,脑损伤可增加骨折局部骨密度,改善骨微结构,提高生物力学性能,以此促进骨折局部的骨愈合和骨代谢。BACKGROUND;Peri-fracture nerve injury can inhibit osteoclast activity and promote early fracture healing.OBJECTIVE;To investigate dynamically the effects of traumatic brain injury on the bone mineral density,microstructure,biomechanics property and bone metabolism in rat models of fractures.METHODS;Sixty-three male rats were randomly divided into three groups;sham group,simple fracture group and fracture combined with brain injury group.After 3,6,and 3 months,the animals were sacrificed in batches under anesthesia,and then,the bones and serum specimens were used to detect the bone mineral density,microstructure,biomechanics property,serum cross-linked N-telopeptide of collagen type I and osteocalcin levels.RESULTS AND CONCLUSION;Compared with the simple fracture group,the fracture combined brain injury group had significantly increased bone mineral density of the proximal tibia,bone volume fraction of the cancellous bone,trabecular thickness,cross-sectional area of tibial cortical bone and total area of the bone marrow,ultimate load and stress of the tibia,serum cross-linked N-telopeptide of collagen type I and osteocalcin levels at 3 and 6 weeks after modeling（P〈0.05）,but no differences in the above-mentioned indexes were found among the three groups at 3 months after modeling.These findings indicate that traumatic brain injury can increase the bone mineral density at the fracture site,improve bone microstructure and enhance biomechanical properties,thereby promoting bone healing and bone metabolism at the fracture site.

关 键 词：组织构建 骨组织工程 脑损伤 骨密度 骨转换 皮质骨微结构 松质骨微结构 骨生物力学 骨代谢 骨钙素 

分 类 号：R318[医药卫生—生物医学工程]