骨髓间充质干细胞+富血小板血浆联合治疗长骨骨折术后骨不连对骨代谢及细胞因子的影响

Effects of bone marrow mesenchymal stem cell combined with platelet-rich plasma treatment of bone nonunion after long bone fracture surgery on bone metabolism and cytokines

目的:研究骨髓间充质干细胞+富血小板血浆联合治疗长骨骨折术后骨不连对骨代谢及细胞因子的影响。方法:选择2011年3月～2017年10月期间因长骨骨折术后骨不连在我院就诊的患者并随机分为两组,联合组接受骨髓间充质干细胞+富血小板血浆联合治疗、对照组接受骨髓间充质干细胞治疗。治疗前及治疗后1个月,测定血清中骨代谢标志物、生长细胞因子的含量以及外周血中骨代谢相关信号分子的表达量。结果:与组内治疗前比较,两组患者治疗后血清中PINP、OPG、BALP、VEGF、TGF-β1、IGF-I、IGF-II、bFGF的含量以及外周血中Runx2、Wnt1、Wnt3a、β-catenin的表达强度均显著升高,血清中β-CTX、RANKL的含量以及外周血中NOX4、NF-κB的表达强度均显著降低且联合组患者治疗后血清中PINP、OPG、BALP、VEGF、TGF-β1、IGF-I、IGF-II、bFGF的含量以及外周血中Runx2、Wnt1、Wnt3a、β-catenin的表达强度均高于对照组,血清中β-CTX、RANKL的含量以及外周血中NOX4、NF-κB的表达强度均低于对照组。结论:骨髓间充质干细胞+富血小板血浆联合治疗长骨骨折术后骨不连能够较骨髓间充质干细胞单独治疗更为有效地改善骨代谢、增加细胞因子。

Objective：To study the effects of bone marrow mesenchymal stem cell combined with platelet-rich plasma treatment of bone nonunion after long bone fracture surgery on bone metabolism and cytokines.Methods：Patients who were treated in our hospital due to bone nonunion after long bone fracture surgery between March 2011 and October 2017 were selected and randomly divided into two groups,combined group received bone marrow mesenchymal stem cell combined with platelet-rich plasma therapy,and control group received bone marrow mesenchymal stem cell therapy.The levels of bone metabolism markers and growth cytokines in serum as well as the expression of bone metabolism-related signal molecules in peripheral blood were determined before treatment and 1 month after treatment.Results：Compared with those of same group before treatment,serum PINP,OPG,BALP,VEGF,TGF-β1,IGF-I,IGF-II and bFGF levels as well as peripheral blood Runx2,Wnt1,Wnt3 aandβ-catenin expression intensity of both groups of patients significantly increased whereas serumβ-CTX and RANKL levels as well as peripheral blood NOX4 and NF-κB expression intensity significantly decreased after treatment,and serum PINP,OPG,BALP,VEGF,TGF-β1,IGF-I,IGF-II and bFGF levels as well as peripheral blood Runx2,Wnt1,Wnt3 aandβ-catenin expression intensity of combined group after treatment were higher than those of control group whereas serumβ-CTX and RANKL levels as well as peripheral blood NOX4 and NF-κB expression intensity were lower than those of control group.Conclusion：Bone marrow mesenchymal stem cell combined with platelet-rich plasma treatment of bone nonunion after long bone fracture surgery can be more effective than bone marrow mesenchymal stem cell monotherapy to improve the bone metabolism and increase the cytokines.