Ⅰ型胶原N末端肽和定量CT骨密度早期测定实验性骨不连  

Early diagnosis of experimental bone nonunion: measurement of N-terminal telopeptide of type Ⅰ collagen and quantitative CT determination of bone mineral density

作　　者：林坚平[1,2] 沈宁江[1] 史占军[2] 王健[2] 肖军[2] 吴多能[1] 张武[1] 

机构地区：[1]海南省人民医院关节外科,海南省海口市570311 [2]南方医科大学南方医院关节外科,广东省广州市510515

出　　处：《中国组织工程研究》2016年第2期162-166,共5页Chinese Journal of Tissue Engineering Research

基　　金：海南省自然科学基金资助课题(808212)~~

摘　　要：背景:目前主要通过传统的X射线诊断骨折不愈合,这种方法仅依赖于临床医师的经验和骨折愈合中骨痂的矿化程度,易受投照、冲洗条件及主观因素影响,精确度欠佳。目的:建立骨折不愈合动物模型,检测其生化指标及骨密度变化规律。方法:将20只新西兰大白兔随机均分为2组,分别在前臂桡骨中段制作骨缺损模型与骨折模型,分别于术前、术后2,3,4,5,6,7,8,10,12周进行前臂的X射线检查、定量CT骨密度测定及血清学检测。结果与结论:X射线显示,骨缺损组中3只兔于术后第2周有少许骨痂形成,但5周后骨痂情况稳定,术后8周仍无愈合;骨折组术后2周开始骨折线模糊,术后6-8周骨痂大量生长。骨缺损组术后5周开始骨密度值明显下降,与骨折组比较差异显著。血清学检测显示,骨缺损组术后骨特异性碱性磷酸酶活性升高,第4周达到高峰,第5周时出现下降,第6周以后数值基本稳定;骨缺损组术后抗酒石酸酸性磷酸酶5b活性升高,在第4周出现峰值,然后下降,基本稳定;骨缺损组Ⅰ型胶原N末端肽在术后5周出现明显下降,术后6周以后基本稳定。说明系统性监测骨密度及生化指标如骨特异性碱性磷酸酶、抗酒石酸酸性磷酸酶5b和Ⅰ型胶原N末端肽的变化可能有助于反映兔骨折不愈合早期进程。Currently, X-ray examination is mainly used for diagnosis of nonunion. However, this method that relies only on the clinician＇s experience and degree of callus mineralization has less accuracy because it is vulnerable to projection, processing conditions and subjective factors. OBJECTIVE： To establish an animal model of nonunion and to detect the variation of biochemical markers and bone mineral density. METHODS： Twenty New Zealand white rabbits were randomly divided into two groups, and bone defect and fracture models were made in the midshaft of the forearm radius, respectively. X-ray examination of the forearm, quantitative CT measurement of bone mineral density and serological test were carried out before and at 2, 3, 4, 5, 6, 7, 8, 10, 12 weeks after surgery.RESULTS AND CONCLUSION： Postoperative X-ray films showed that the in the bone defect group, a little callus formed in three rabbits at 2 weeks, the callus formed stably at 5 weeks, but there was still no healing at 8 weeks; in the fracture group, the fracture line was blurred at 2 weeks and a large number of calluses formed at 6-8 weeks. Compared with the fracture group, the value of bone mineral density in the bone defect group began to decrease significantly at 5 weeks after surgery. Results from the serological test showed that in the bone defect group, the activity of bone-specific alkaline phosphatase increased after surgery, reached peak at 4 weeks, began to decrease at 5 weeks and became stable at 6 weeks; the activity of tartrate-resistant acid phosphatase 5b increased after surgery, peaked at 4 weeks, then decreased and stabilized basically; the expression of N-terminal telopeptide of type I collagen decreased significantly at 5 weeks after surgery and became stable at 6 weeks. These findings indicate that the systematic monitoring of changes in bone mineral density and biochemical indicators such as bone-specific alkaline phosphatase, tartrate-resistant acid phosphatase 5b and type I collagen N-terminal telopeptides may help to reflect

关 键 词：模型 动物 碱性磷酸酶 骨密度 组织工程 组织构建 骨组织工程 骨不连 生物标志物 抗酒石酸酸性磷酸酶5B Ⅰ型胶原N末端肽 骨特异性碱性磷酸酶 ELISA 海南省自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]