OPG及RANKL在儿童先天性胫骨假关节病变骨与骨膜中的表达研究

Expressions of OPG and RANKL in tibia bone and periosteum of patients with congenital tibial pseudarthrosis of the tibia in children

目的通过免疫组化检测儿童先天性胫骨假关节和胫骨骨折患儿骨与骨膜标本中骨保护素(OPG)、核因子κB受体活化因子配体(RANKL)的表达水平,明确OPG及RANKL在儿童先天性胫骨假关节骨与骨膜中的表达差异,并分析其可能的意义。方法选取2016年1月至2018年2月由湖南省儿童医院收治的17例儿童先天性胫骨假关节(CPT组)和10例胫骨骨折患儿(对照组)作为研究对象。采用SABC法检测先天性胫骨假关节患儿和对照组骨及骨膜中OPG、RANKL的表达,并分析其差异性。结果本研究发现OPG在CPT组(0.08±0.03)骨膜中的表达量低于对照组(0.11±0.02),差异有统计学意义(t=2.805,P<0.01);RANKL在CPT组(0.24±0.07)骨膜中的表达量高于对照组(0.15±0.04),差异有统计学意义(t=3.707,P<0.01);CPT组(2.37±0.29)病变胫骨骨膜中RANKL/OPG比值高于对照组(1.09±0.16),差异有统计学意义(t=12.792,P<0.01)。OPG在CPT组(0.17±0.09)胫骨中的表达量低于对照组(0.26±0.05),差异有统计学意义(t=2.895,P<0.01);RANKL在CPT组胫骨中的表达量(0.68±0.13)高于对照组(0.33±0.09),差异有统计学意义(t=7.494,P<0.01);RANKL/OPG比值在CPT组(5.12±0.60)胫骨中的表达量高于对照组(1.12±0.17),差异有统计学意义(t=25.784,P<0.05)。结论RANKL/OPG失衡可能是儿童先天性胫骨假关节出现胫骨不愈合和骨吸收的原因之一。

Objective To explore the expressions of osteoprotegerin(OPG)and nuclear factor kappa B receptor activator ligand(RANKL)in tibia bone and periosteum of patients with congenital tibial pseudarthrosis of the tibia(CPT)and tibial fracture in children and analyze its possible significance.Methods From January 2016 to February 2018,17 cases of tibia bone and periosteum of CPT and 10 cases of tibia bone and periosteum of tibial fracture were collected.Strep Avidin-Biotin Complex method was employed for measuring the expressions of OPG and RANKL in bone and periosteum of two groups.Results The expression of OPG in tibial periosteum of CPT patients was lower than tibial fracture counterparts[(0.08±0.03)vs.(0.11±0.02),t=2.805,P<0.01].And the expression of RANKL in tibial periosteum of CPT patients was higher than tibial fracture counterparts[(0.24±0.07)vs.(0.15±0.04),t=3.707,P<0.01].RANKL/OPG ratio was higher in tibial periosteum of CPT than that in tibial fracture counterparts[(2.37±0.29)vs.(1.09±0.16),t=12.792,P<0.01].The expression of OPG was lower in tibial bone of CPT patients than that in tibial fracture counterparts[(0.17±0.09)vs.(0.26±0.05,t=2.895,P<0.01].And the expression of RANKL was higher in tibial bone of CPT patients than that in tibial fracture counterparts[(0.68±0.13)vs.(0.33±0.09),t=7.494,P<0.01].RANKL/OPG ratio was higher in tibial bone of CPT patients than that in tibial fracture counterparts[(5.12±0.60)vs.(1.12±0.167,t=25.784,P<0.05].All differences were statistically significant.Conclusion RANKL/OPG imbalance may be one of the causes of nonunion and bone resorption in CPT children.