碱性成纤维细胞生长因子及血小板源性生长因子在人股骨颈骨折中的表达及相互关系

Expression and relationship of basic fibroblast growth factor and platelet-derived growth factor in femoral neck fracture

目的 研究股骨颈骨折后不同时期碱性成纤维细胞生长因子（bFGF）及血小板源性生长因子（PDGF）的表达及分布特点。方法应用免疫组化PV超敏法对36例人股骨颈骨折标本中bFGF、PDGF蛋白进行检测，应用CMIAS真彩色医学图像分析系统对各组免疫组化结果进行吸光度（A）检测及分析，同时对bFGF、PDGF表达进行相关性分析。结果①伤后1周组9例，bFGF蛋白在骨折处间充质细胞、单核细胞、血管内皮细胞表达最为显著，A为（0．4076±0．0902）；PDGF蛋白在间充质细胞内呈弱阳性表达，而在血管内皮细胞内呈强阳性表达，A为（0．2261±0．0636）。伤后2周组9例，bFGF、PDGF表达于成纤维细胞、血管内皮细胞、新生的软骨细胞及基质、成骨细胞中，A分别为（0．6404±0．0920）和（0．7457±0．0756），与伤后1周比较，差异有统计学意义（P〈0．05，P〈0．01）。伤后3周组9例，bFGF及PDGF蛋白表达的OD分别为（0．7168±0．1346）和（0．8033±0．0491），与伤后2周相比差异无统计学意义（P均〉0．05）。伤后4周组9例，成熟的骨组织、软骨组织中bFGF、PDGF蛋白均呈弱阳性或阴性反应，但幼稚骨组织、软骨组织中则呈阳性表达，OD分别为（0．5374±0．1210）和（0．7068±0．1255），但表达程度低于伤后3周（P均〈0．05）。②股骨颈骨折后1、2、3、4周bFGF与PDGF蛋白表达均成正相关（r分别为0．792、0．834、0．880、0．766，P均〈0．05）。结论①bFGF在骨折愈合早期能诱导间充质细胞、成骨细胞、软骨细胞及血管内皮等细胞的分裂、增殖，促进新生血管及新骨的生成。②PDGF是骨细胞调节剂，可刺激软骨细胞和成骨细胞的增殖、分化并可间接地诱导血管内皮细胞增殖与新生血管生成。③bFGF及PDGF均为骨性生长因子，二者互相促进，共同调节成骨细胞及血管增殖和分化，最终完成骨折修复过程。

Objective To investigate the expression and distribution of basic fibroblast growth factor （bFGF） and platelet-derived growth factor （PDGF） in the different phases of femoral neck fracture. Methods Immunohistochemical assays were used to determine the expression and distribution of bFGF and PDGF protein in 36 human specimen of femoral neck fracture. A was measured and analyzed by CMIAS color imaging analysis system for immunohistochemical results and the correlation between bFGF and PDGF was analyzed. Results ①The positive signals of bFGF protein were found high in the mesenchymal cells, monocyte and vascular endothelial cells at 1 st week after fracture in 9 subjects, with A of （0.4076 ±0. 0902 ）. The weakly positive signals of PDGF protein were found in the mesenehymal cells, while strongly positive in the vascular endothelial cells with A of （0. 2261 ＋ 0. 0636）. At 2rd week, in 9 cases the expression of bFGF and PDGF was strongly expressed in fibroblasts, endothelial cells, cartilage cell and cartilage matrix, osteoblast , with A of [ （0. 6404 ± 0. 0920 ） and （0. 7457 ＋ 0. 0756） ] and significantly higher than that at 1 st week （P 〈 0.05 ,P 〈0.01 ）. There was no significant difference between the 3rd and 3nd week with A of [ （0. 7168 ± 0. 1346） and （0. 8033 ± 0. 0491 ）, P 〉 0. 05 ]. The expression of bFGF and PDGF protein was reduced obviously at 4th week but was positive in young and cartilage tissue, with A of [ （0. 5374 ±0. 1210） and （0.7068 ±0. 1255） ] ,which was lower than that at 3rd week （P 〈0.05） . ②There was positive correlation between bFGF and PDGF protein in different phases （r1week = 0. 792, r2week = 0. 834, r3week = 0. 880, r4week = 0. 766, P 〈 0.05 ）. Conclusion ①In the initial period, bFGF could induce mitosis and proliferation of cells and promote fracture healing and new blood vessel and bone growth. ②PDGF could regulate proliferation and differentiation of cartilage cell and osteoblast, and induce proliferation of vascular endothelial cells and new blood vessel. ③Both bFGF and PDGF are bone growth factors.coooerating in reaulating proliferation and differentiation of cartilage cell and osteoblast for fracture healing.