牛骨形态发生蛋白复合物对大鼠骨质疏松性椎体骨折愈合效果的影响

Effect of bovine bone morphogenetic protein complexes on healing effect in rats with osteoporotic vertebral fractures

目的观察牛骨形态发生蛋白复合物对大鼠骨质疏松性椎体骨折愈合效果的影响。方法选取SPF级8个月雌性大鼠84只,按照随机数字表法分为实验组、模型组和假手术组各28只。实验组和模型组经双侧卵巢去除术建立骨质疏松模型,假手术组只于背部卵巢周围切除等体积脂肪。三组术后3个月均建立人工椎体骨折模型(L5椎体开窗),实验组大鼠模型骨折区给予10 mg牛骨形态发生蛋白复合物,模型组和假手术组于骨折区注入等体积小牛血清。建立骨折模型后28 d、42 d、56 d三组分别处死3只大鼠,免疫组化法检测椎体切片骨折愈合情况;然后于42 d、56 d、84d各组分别另处死3只大鼠,测试椎体力学性能(最大应变量、弹性模量、载荷能力)。结果骨折模型建立28 d三组均有骨纤维形成,但模型组骨痂及软骨细胞形成数量明显少于实验组和假手术组;42 d时实验组和假手术组均可见较多骨性骨痂和成熟骨小梁,模型组却仅见软骨岛,其它组织却结构混乱;56 d时实验组和假手术组骨折基本愈合,模型组尚有缺损。建立骨折模型42 d、56 d、84 d三组椎体最大应变量、弹性模量和最大载荷对应时点比较,实验组与假手术组无显著差异(P>0.05),模型组显著低于其它两组(P<0.05)。结论牛骨形态发生蛋白复合物可加快促进大鼠骨质疏松性椎体骨折愈合速度,并提高其愈合质量,同时椎体抗负荷能力也显著升高,用于治疗骨质疏松性椎体骨折患者可行性高。

Objective To observe the effect of bovine bone morphogenetic protein complexes on healing effect in rats with osteoporotic vertebral fractures. Methods Eighty - four female rates of SPF grade and 8 months were selected and divided into experimental group, model group and sham operation group with 28 rats in each according to the random digital table method. The experimental group and the model group were established by bilateral ovarian removal osteoporosis model, while the sham operation group were only given resection of the volume of fats on the back around the ovary. The three groups were established artificial vertebral fracture model （L5 of vertebral window） after 3 months of opera-tion. The rats in the experimental group were given 10mg of bovine bone morphogenetic protein complexes around fracture zone, which in the model group and sham operation group were given equal volume calf serum around fracture zone. 3 rats in each group were killed after 28 d, 42 d, 56 d of the establishment of fracture model, and the fracture healing of vertebral body was detected by immunohistochemistry method. Then 3 rats in each group were killed after 42 d, 56 d , 84 d of the establishment of fracture model, and the mechanical properties of vertebral bodies （maximum stress, elastic modulus, load capacity） were tested. Results T h e three groups had bone fiber formation at 2 8 d after the establishment of fracture model, but the number of callus and cartilage cell formation in the model group were obviously less than those in the experimental group and sham operation group. At 42 d, in both experimental group and sham operation group, there were more bony callus and mature bone, while there was only cartilage island in the model group, and other organizations were in a mess. The fractures were basic healing in the experimental group and sham operation group at 56 d, while there were defects in the model group. There were no significant differences in the maximum stress, elastic modulus and maximum load among the three groups at 42 d , 56 d and 84 d after the establishment of fracture model （ P 〉 0 . 05） , and the indexes in the model group were significantly lower than those in the other groups （ P 〈 0 . 0 5 ） . Conclusion Bovine bone morphogenetic protein complexes can accelerate the promotion of osteoporotic vertebral fracture healing rate, and improve the quality of its healing, while the vertebral body anti load capacity is also significantly increased, with high feasibility for the treatment of patients with osteoporotic vertebral fracture.