雌激素与辛伐他汀序贯疗法对去势大鼠种植体骨愈合影响的骨计量学研究

Sequential estrogen and simvastatin therapy on bone healing in ovariectomized rats implant quantitative study of bone

目的:观察序贯应用雌激素(骨吸收抑制剂)和辛伐他汀(骨形成刺激剂)对去势骨质疏松大鼠种植体骨愈合骨计量的影响。方法:选用32周龄雌性SD大鼠40只,并随机分为正常对照组(A组)和去势组。去势组切除双侧卵巢,正常对照组只进行耻区皮肤单纯切开术。卵巢切除12周后于大鼠胫骨近骺端植入纯钛螺纹状种植体并将去势组随机分为4组:雌激素组(B组)、辛伐他汀组(C组)、序贯组(D组)和去势对照组(E组)。雌激素组:皮下注射苯甲酸雌二醇0.1 mg/kg,3 d给药1次;辛伐他汀组:5 mg/kg,1 d灌胃1次;序贯组:皮下注射苯甲酸雌二醇0.1 mg/kg,3 d给药1次,2周后,灌胃给予辛伐他汀5 mg.kg-1.d-12周,停药5周,再应用辛伐他汀5 mg.kg-1.d-1灌胃3周;去势对照组:单纯饲料喂养,无药物干预。种植术后12周全部处死,摘取胫骨。标本制作带种植体的不脱钙切片,行骨计量学观察。结果:比较结合骨板宽度,骨小梁直径,松质骨区种植体-骨接触率及松质骨区骨量,D组与A,B,C,E组差异有显著性(P<0.05)。结论:实验性骨质疏松可阻碍种植体和骨组织的结合,使种植体周围骨小梁减少,结合骨板和骨小梁变得菲薄,序贯疗法可有效促进骨形成,从而提高骨组织对种植体的支持。

Objective：To observe the influence of sequential using estrogen（bone resorption inhibiter） and simvastatin（bone resorption irritant） towards bone healing and bone dosimetric of implants of castrative rats with osteoporosis.Methods：Forty female 32-week SD rats were adopted and randomly divided into normal control group（A group） and castrative group.Bilateral ovarians of the rats in castrative group were excised.The rats in normal group adopted simple skin incision of the lower abdomen.The titanium screw-shaped implants were embedded near the end of epiphyseal tibia in 12 weeks after ovariectomy.Then the castrative group was divided into four groups：estrogen group（B group）,simvastatin group（C group）,sequential using group（D group） and castrative control group（E group）.Estrogen group：0.1 mg/kg estradiol benzoate was injected subcutaneously,1/3 d;simvastatin group：5 mg·kg-1·d-1simvastatin was lavaged once;sequential using group：0.1 mg/kg estradiol benzoate was injectedsubcutaneously,1/3 d.After 2 weeks 5 mg·kg-1·d-1simvastatin was lavaged for 2 weeks.After withdrawl for 5weeks,simvastatin was lavaged for 3 weeks again.Control group：the rats were fed on simple fodder,and no drugs was adopted.All rats were sacrificed in 12 weeks after implanted,the tibias were removaled.The undecalcified sections specimen with implants were made to bone dosimetric observation.Results：Combined with plate width,trabecular diameter,area of cancellous bone implant-bone contact rate and the volume of trabecular bone,D group were significantly different from A,B,C,E groups.（P〈0.05 or P〈0.01）.Conclusion：Experimental osteoporosis can hinder implants from binding with bone tissues,decrease the trabecular bone around implants,make plate bone and trabecular bone thin.Sequential using drugs can promote bone formation effectively to improve the support of bone tissue on the implant.