体外冲击波对大鼠骨质疏松性骨折愈合作用的实验研究

Experimental research of the effect of extracorporeal shock wave therapy on osteoporotic fracture healing in rats

目的研究体外冲击波是否能够通过增强骨折骨痂形成、矿化等来促进骨质疏松骨折愈合，为临床应用体外冲击波疗法治疗骨质疏松提供理论依据。方法将3个月龄SD大鼠随机分为治疗（卵巢摘除术后＋体外冲击波治疗）组18只，对照（卵巢摘除术后）组18只，假卵巢摘除术组6只。建立大鼠骨质疏松及骨折模型。确定模型建立后，对治疗组大鼠的骨折部位处行体外冲击波治疗。治疗组及对照组分别在骨折术后4周及8周后随机抽取大鼠进行X线、显微CT检查。结果X线显示，在造模后第4周时，治疗组骨痂密度增高面积比例大于对照组，两组差异无统计学意义（P=0．284），在第8周时，治疗组的骨折端基本已完全骨性桥接，相对于对照组，差异有统计学意义（P=0．008）；显微CT结果显示在第4、8周时，冲击波治疗组的大鼠股骨骨折部位的骨密度分别为（467．0±43．8）mg／mm。与（465．0±51．3）mg／mm^3，明显高于对照组（437．0±36．2）mg/mm^3与（426．0±33．2）mg／mm^3（P值分别为0．023、0．001）；治疗组骨小梁数量（1．40±0．42）个／mm与（1．41±0．37）个／mm明显高于对照组（1．24±0．33）个／mm与（1．13±0．17）个／mm（P值分别为0．041、0．001）。结论体外冲击波疗法能有效促进大鼠骨质疏松性骨折的愈合。

Objective To study the extracorporeal shock wave （ESW） whether can by enhancing fracture callus formation and mineralization to promote osteoporosis bone fracture healing, in order to provide the theory evidence of the clinical application of ESW therapy in the treatment of osteoporosis. Methods Three months old SD rats were randomly divided into 3 groups： 18 cases of treatment group（ ovarian castration（OVX） ＋ ESW） , 18 cases of control group（OVX） , and 6 cases of false ovarian castration group. Established the rat model of osteoporosis and bone fracture. After determined the establishment of the model, ESW therapy was performed on the fracture line of rats in the treatment group. X-ray and Micro-CT examination were performed in rats of treatment group and control group at 4 weeks and 8 weeks after operatiQn respectively randomly. Results X-ray showed that, 4 weeks after operation, the proportion of increase area of callus density of treatment group was bigger than the control group, but no significant difference in the two groups （P = 0. 284） . At the 8th week, the fracture of treatment group was basically complete bony bridging compared to the control group, and there was statistically significant difference in the two groups（P= 0. 008） . Micro-CT showed that, at the 4th and 8th week, the bone mineral density （BMD） of femoral fracture of rats in ireatment group were （ 467.0 ± 43.8） mg/mm^3 and （465.0± 51.3） mg/mm^3, significantly higher than control group （ （437. 0±36. 2） mg/mm^3 and （426.0±33. 2 ） mg/mm^3 ; P = 0. 023, 0. 001 ） . Trabecular number （ Tb. N） of rats in treatment group were （1.40±0. 42） number/mm and （1.41±0. 37） number/mm, significantly higher higher than control group （（1.24±0.33） number/mm and （1.13 ＋0.17） number/mm; P=0.041,0.001） . Conclusion ESW effectively promotes the rat osteoporotic fracture healing.