促进骨折愈合的实验研究

Experimental study on accelerating the heal of bone fracture

目的:探讨体外冲击波(ESW)对骨痂中碱性成纤维细胞生长因子(bFGF)的影响,进一步揭示ESW治疗骨折的机制。方法:将20只健康家兔制备成双桡骨骨缺损模型,右上肢骨缺损为实验组,左上肢骨缺损为对照组,1周后伤口愈合,全麻下实验组行体外冲击波治疗,一次完成,在骨缺损两断端相应部位各冲击1000次,能量为13kV,频率为60次/min,对照组不作治疗。分别于术后第4、6周摄X线片观察骨缺损处成骨情况,取骨缺损处骨痂组织标本,通过组织学观察组织细胞的增殖情况,通过免疫组化检测骨痂中bFGF的表达。结果:实验组骨痂中bFGF含量明显高于对照组,实验组中,骨细胞、成纤维细胞、毛细血管、成骨细胞、间充质细胞等细胞增生活跃。结论:bFGF可在体外冲击波刺激下表达增强,使细胞增殖分化,促进骨折愈合。

Objective： To investigate the effect of extracorporeal shock wave（ESW） on the basic fibroblast growth factor （bFGF） in the bony callus, and further detect the therapeutic mechanism of ESW to bone fracture. Methods： 20 healthy domestic rabbits were employed to prepare the animal models of the double radial bone defect and damage, the bone defect of the right upper extremity was served as the experimental group and the bone defect of the left upper extremity was served as the control group, after the wound healed about one week, the right upper extremity was performed with ESW under general anesthesia, carried to the correspond part at the bone defect and damage two pieces, with each pound for 1000 times, the energy was 13 kV, with a frequency of 60 times/min, the left upper extremity was not performed ESW. Then X-ray photo was taken to observe the condition of bone defect after 4 weeks and 6 weeks. The bone defect＇s bony callus organization specimen was taken to perform the histology-checking to observe the proliferation of histocytes, and immunohistochemistrychecking was then used to observe the expression of bFGF. Results： The bFGF content in the bony callus of the ESW experimental group was significantly higher than that in control group, and the bone cells, fibroblasts, blood capillary as well as the skeletogenous cells proliferated actively in the experimental group than that in control group. Conclusion： The bFGF expression can be increased under the ESW＇s stimulation, which promotes the cell proliferation and differentiation, and promotes the heal of the bone fracture.