甲状旁腺激素促进下颌骨髁突骨折游离复位模型兔的骨愈合  

Parathyroid hormone promotes bone healing in rabbits after free reduction of mandibular condyle fractures

作　　者：黄志才 谢柳琴 王光素 张国兴 唐正龙 Huang Zhicai;Xie Liuqin;Wang Guangsu;Zhang Guoxing;Tang Zhenglong(Guizhou Medical University School of Stomatology/Affiliated Stomatological Hospital,Guiyang 550004,Guizhou Province,China)

机构地区：[1]贵州医科大学口腔医学院/附属口腔医院,贵州省贵阳市550004

出　　处：《中国组织工程研究》2022年第14期2172-2178,共7页Chinese Journal of Tissue Engineering Research

基　　金：贵州省教育厅特色领域项目(黔教合KY字[2021]067),项目负责人:唐正龙;贵州省科技计划项目(黔科合基础[2017]1151),项目负责人:唐正龙。

摘　　要：背景:髁突骨折时若骨块严重移位需手术复位及内固定,若附着于髁突前内侧的翼外肌剥脱使骨块游离,术后可能发生髁突骨折块延迟愈合,因此如何促进髁突骨折游离复位后愈合是口腔颌面外科临床医师关注的临床难题。目的:探讨间歇性皮下注射甲状旁腺激素对兔髁突骨折游离复位后骨愈合的影响及作用机制。方法:将48只新西兰大耳兔随机分为实验组及对照组,每组24只,建立下颌骨髁突骨折游离复位内固定模型,实验组及对照组造模术后隔日分别经皮下注射甲状旁腺激素20μg/kg或生理盐水1 mL。术后第1,2,3,4周时麻醉处死动物,取术区骨标本观察愈合情况,利用免疫组织化学染色及实时荧光定量PCR检测骨折区域骨保护素和核因子κB受体活化因子配体的表达水平。结果与结论:①实验组骨折区域成骨细胞较多、新生骨痂较快且密度较高;②术后前4周内实验组破骨细胞数量较对照组少(P<0.05);③骨保护素的免疫组化平均吸光度值及mRNA表达量结果显示,4周内实验组均高于对照组(P<0.05);④核因子κB受体活化因子配体的免疫组化平均吸光度值及mRNA表达量结果显示,4周内实验组均低于对照组(P<0.05);⑤提示下颌骨髁突骨折游离复位术后隔日使用甲状旁腺激素,在术后早期可上调骨折区域骨保护素表达、抑制RANKL表达,促进骨折区域的新骨生成。BACKGROUND:Surgical reduction and internal fixation are used as the main treatments for severe displacement of condylar fracture.If a bone fragment is disintegrated due to the peeling of the external pterygoid muscle,complications such as delayed healing of condylar fracture block may occur after surgery.Therefore,how to promote bone healing after free reduction of condylar fracture is of concern to clinicians in maxillofacial surgery.OBJECTIVE:To study the effect of intermittent administration of parathyroid hormone on bone healing after free reduction of condylar fracture in rabbits.METHODS:Forty-eight New Zealand rabbits were randomly divided into experimental group and control group,24 rabbits in each group.An experimental model of free reduction and fixation of mandibular condylar fracture was established in rabbits.The experimental group and control group were respectively subcutaneously injected with 20μg/kg parathyroid hormone and 1 mL of normal saline on the next day after surgery,respectively.The animals were sacrificed 1,2,3 and 4 weeks after surgery.Bone samples at the surgical site were taken for bone healing observation.The expression of osteoprotegerin and receptor activator of nuclear factor kappa B ligand(RANKL)in the fracture area was detected by immunohistochemical staining and real-time fluorescence quantitative PCR.RESULTS AND CONCLUSION:There were more osteoblasts and new callus formed faster in the fracture area with a higher density in the experimental group.In the first 4 weeks after surgery,the number of osteoclasts in the experimental group was less than that in the control group(P<0.05).The mean absorbance value and mRNA expression level of osteoprotegerin were higher in the experimental group than the control group within 4 weeks after surgery.The mean absorbance value and mRNA expression level of RANKL were lower in the experimental group than the control group within 4 weeks after surgery(P<0.05).All these findings indicate that the application of parathyroid hormone on the second

关 键 词：下颌骨 髁突骨折 甲状旁腺激素 骨保护素 核因子ΚB受体活化因子配体 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]