体外冲击波对骨质疏松兔股骨髁部松质骨影响的实验研究

Effect of extracorporeal shock wave on femoral condyle trabecular bone in an osteoporosis rabbit model

目的观察体外冲击波对骨质疏松兔股骨髁部松质骨的成骨作用。方法采用卵巢切除法(OVX)对30只5月龄雌性新西兰兔去势,5个月后建立骨质疏松模型。所有动物随机分为3组,每组10只,其中一组为空白对照组(A组),其余两组(B组和C组)动物右侧股骨髁部进行体外冲击波(ESW)处理,冲击波能流密度0.47 mJ/mm2,脉冲2000次。于处理前、处理后4、8 w时分3批处死动物,分离右侧股骨远端,进行micro-CT测量分析。结果micro-CT三维重建分析表明,冲击波处理后4w(B组)及8 w(C组)时实验组的BMD、BMC和骨小梁立体测量学的指标与对照组的差别有统计学意义,其中C组的BMD分别比A组和B组增高79.9%和14.0%,尽管C组在BMD、BMC和骨小梁立体测量学等指标方面均较B组优,但两组测量结果的差别无统计学意义。结论体外冲击波可以促进骨质疏松被处理局部骨小梁的改建,改善骨小梁的三维结构,增加骨质密度。

Objective To investigate the treatment effects of extracorporeal shock wave（ESW） on femoral condyle in an osteoporosis rabbit in vivo.Methods Thirty New Zealand white rabbits were ovariectomied for 5 months to establish osteoporosis animal model.All animals were randomized into 3 groups： group A（sham）,group B（4 weeks of treatment） and C（8 weeks of treatment）.In group B and C,high-energy shock wave（energy flux density： 0.47mJ/mm^2,2000 impuls） was applied to the right femoral condyles.All animals were sacrificed 4（group B） or 8（group C） weeks after ESW treatment and underwent micro-CT scan.Results Micro-CT analysis showed that bone mineral density（BMD）,bone mineral content（BMC） and micro-architectural parameters in group B and C were significantly higher than those in group A.The BMD in group C was 79.9% and 14.0% higher than that in group A and group B respectively.Although BMD,BMC and micro-architectural parameters in group C were higher than those in group B,no significant differences were detected between the two groups.Conclusions ESW can improve the reconstruction and remodeling of cancellous bone and increase the BMD and BMC in the osteoporosis rabbit model.It can be used as local treatment for osteoporosis.