血糖波动对糖尿病大鼠胫骨种植体骨结合的影响及机制研究

Discussion of the Effect and Mechanism on Blood Glucose Fluctuations Diabetic Rats Tibial Implant Bone

目的探讨血糖波动对糖尿病大鼠胫骨种植体骨结合率的影响及其作用机制。方法选取48只雄性大鼠作为研究对象,将其随机分为正常对照组、血糖波动组以及持续高血糖组。对三组大鼠进行糖耐量试验,并对三组大鼠胫骨种植体骨结合率以及种植体周围骨组织TGF-β1表达水平进行对比分析。结果血糖波动组以及持续高血糖组耐量试验均出现了异常。且血糖波动组大鼠各时间点血糖水平均明显高于持续高血糖组大鼠,差异显著具有统计学意义(P<0.05)。术后4 w,血糖波动组以及持续高血糖组大鼠胫骨种植体骨结合率均明显低于正常对照组,差异具有统计学意义(P<0.05)。术后8 w及12 w血糖波动组大鼠胫骨种植体骨结合率明显低于持续高血糖组,差异具有统计学意义(P<0.05)。术后12 w正常对照组TGF-β1表达水平明显高于血糖波动组以及持续高血糖组,而持续高血糖组TGF-β1表达水平高于血糖波动组,差异均具有统计学意义(P<0.05)。结论血糖波动对种植体骨结合率有抑制作用,且该作用对种植体周围骨结合的影响大于持续性高血糖。

Objective To discuss the effect and mechanism of blood glucose fluctuation on osseointegration around implant in type 2 diabetic rats. Methods Forty- eight male Sprague Dawley rats had been divided into normal control group three groups randomly. One of them was normal control group,the anther one of them was consistent high blood glucose group,and another group was glucose fluctuation. Glucose tolerance test and the bone- implant contact of the rat tibia bone implant were carried out on the three groups of rats. The TGF- beta 1 expression level also be analyzed. Results Glucose tolerance test of the consistent high blood glucose group and the were exception. And that glucose level of the glucose fluctuation group at every point in time was significantly higher than that of the consistent high blood glucose group（ P〈0. 05）. A titanium implant treated by micro- arcoxidation surface was planted into the right tibia bone of every rat. Killed the rats and harvested the tibia containing implants respectively at 4,8 and 12 weeks,and analyzed the osseointegration by the undecalcified tissue slices. At 4 weeks,the percentage of bone- implant contact（ BIC） in both experimental groups was less than in normal control group（ P〈0. 05）. At 8 weeks,the BIC in glucose fluctuation group was less than in consistent high blood glucose group（ P〈0. 05）. At 12 weeks,the TGF- beta 1 expression level in normal control group was more than that in both experimental groups,and the TGF- beta 1 expression level in consistent high blood glucose group was more than that in glucose fluctuation group. Conclusion Blood glucose fluctuation could restrain the osseointegration around implant in type 2 diabetic rats,and the effect may be obvious than consistent high blood glucose.