大鼠颅脑损伤合并四肢骨折加速愈合的原因研究

Limb fracture in traumatic brain injury in rats accelerated the healing of the reasons for Research

目的通过测定血清中BMP-2浓度的变化,寻找颅脑损伤合并四肢骨折患者骨折加速愈合的直接原因。方法取28只大鼠,随机分为3组,制作动物模型。第一组:重型颅脑损伤合并股骨干骨折;第二组:单纯股骨干骨折组;第三组:对照组。脑损伤组按Gruner改良法制作中度脑损伤模型。骨折组取一侧股骨,在其中段处横断,以直径1.5 mm的克氏针作髓内固定。正常对照组不作任何处理。正常对照组于实验开始后第3 d,其他2组分别于术后1 d,3 d,1,2,3周采用ABC-ELISA法测定化血清中BMP-2含量。脑损伤合并骨折组、单纯骨折组分别于术后1,2,3周取骨折标本进行拍片,观察骨折生长情况。结果⑴骨折组术后1周血清BMP-2含量高于正常对照组P<0.05,第3周降至正常。脑损伤+骨折组术后第3 d血清BMP-2含量明显高于正常对照组,术后第3 d及第1～2周时脑损伤+骨折组血清BMP-2含量高于单纯骨折组,差异均有统计学意义(P<0.05);⑵在X摄线片分析中,脑损伤+骨折组术后骨折生长时间短于单纯骨折组。结论颅脑损伤时,血清中BMP-2的表达增高,可能是骨折加速愈合的原因之一。

Objective To find the direct reasons of the bone accelerated union in the patients who had the heavy head injury and the limb trauma by determinating the bone morphogenetic protein（BMP-2） consistency in the blood serum of the rat model. Methods To make animal model, thirty rats were distributed three groups by random, the first group is the heavy head injury with the limb fracture; the second group is the femur fracture group; The third group is normal control group. Accord to Gruner way to manufacture the brain damage model. To make fracture model, find femur and transect at the middle point, inter fixation by kirschner wire which diamiter was 1.5 millimeter. The normal group was not treated. Postoperation draw blood at the first day, the third day, the first week, the second week and the third week and ditect the BMP-2 consistency by sandwich-ELISA .the rat which femur fracture and the brain injury with fracture were X-ray inspection at the week of the first, second and third and to observe the fracture growth. Results （1）Postoperation at the first week, the fracture group BMP-2 consistency in blood serum was higher than the normal group（P〈0.05）, at the third week, descend to two times than normal. Postoperation at the third day, the brain injury with the limb fracture group BMP-2 consistency in blood serum was obviously higher than the normal group（P〈0.05）, and higher than the fracture group between the third day to the second week, the difference had prominence significance（P〈0.05）. （2）In grapical analysis, the fracture union time among the brain injury with the limb fracture group was shorter than the only fracture group. Conclusion the rat which had heavy brain injury with limb fracture BMP-2 expression increasing in blood serum, and to be sure BMP-2 is one of the most important humoral factor.