不同程度大鼠颅脑损伤股骨骨折骨愈合比较

Comparison of bone healing of femoral fracture in rats with different extents of craniocerebral injury

[目的]探究大鼠不同程度创伤性颅脑损伤(traumatic brain injury, TBI)合并单侧股骨骨折愈合的影响,以及降钙素基因相关肽(calcitonin gene-related peptide, CGRP)及骨保护素(osteoprotegerin, OPG)/核因子κB受体活化因子配体(receptor activator of nuclear factor-κB ligand, RANKL)在其中的作用。[方法] 80只雄性11周龄大鼠随机分为4组,每组20只,按照神经功能缺损评分(neurological severity score, NSS)标准建立模型,分为单纯股骨骨折(无损伤组)、轻度TBI合并股骨骨折(轻度组)、中度TBI合并股骨骨折(中度组)、重度TBI合并股骨骨折(重度组)。比较骨折愈合情况及血清检测结果。[结果]无损伤组、轻度组、中度组和重度组术后6周骨折愈合X线评分为[(1.0±0.7) vs (1.0±0.7) vs (1.8±0.5) vs (1.8±0.5), P<0.001],骨痂体积为[(418.6±25.7) mm3vs (414.3±29.6) mm3vs (689.8±31.2) mm3vs (681.4±31.8) mm3, P<0.001],其中度组和重度组显著高于无损伤组和轻度组。血清检测方面,无损伤组、轻度组、中度组和重度组术后6周的CGRP [(10.9±0.9) pg/ml vs (11.1±0.7) pg/ml vs(15.2±0.6) pg/ml vs (15.6±0.5) pg/ml, P<0.001]、OPG [(1 131.6±49.9) pg/ml vs (1 180.6±49.3) pg/ml vs (1 443.8±42.3) pg/ml vs (1 457.6±43.8) pg/ml, P<0.001]、RANKL [(66.1±6.8) pg/ml vs (68.3±5.4) pg/ml vs (49.5±5.8) pg/ml vs (50.2±6.0) pg/ml, P<0.001]、OPG/RANKL[(17.2±1.1) vs (17.3±0.7) vs (29.4±2.7) vs (29.3±2.6), P<0.001],上述指标,中度组和重度组与无损伤组和轻度组之间差异均有统计学意义。[结论]中、重度组可以有效促进骨折端骨痂生长,缩短骨折愈合时间,这可能与血清中CGRP浓度与OPG/RANKL表达比值升高有关。

[Objective]To investigate the effects of traumatic brain injury(TBI)on unilateral femoral fracture healing in rats in termsof calcitonin gene-related peptide(CGRP),and osteoprotegerin(OPG)/receptor activator of nuclear factor-κB ligand(RANKL).[Meth-ods]A total of 8011-week-old male rats were randomly divided into 4 groups with 20 rats in each group.A model was established accord-ing to neurological severity score(NSS)and the rats were divided into simple femoral fracture(non-injury group)and mild TBI combinedwith femoral fracture(mild group),moderate TBI with femur fracture(moderate group),and severe TBI with femur fracture(severe group).The data of fracture healing and serum assays were compared.[Results]The noninjury group,mild group,moderate and severe groupwere measured X-ray score[(1.0±0.7)vs(1.0±0.7)vs(1.8±0.5)vs(1.8±0.5),P<0.001]and callus volume[(418.6±25.7)mm3 vs(414.3±29.6)mm3 vs(689.8±31.2)mm3 vs(681.4±31.8)mm3,P<0.001]6 weeks after operation,of which the moderate and severe groups were significant-ly higher than the non-injury and mild groups.Regarding to serum assay,the non-injury group,mild group,moderate group and severegroup at 6 weeks after surgery were assayed CGRP[(10.9±0.9)pg/ml vs(11.1±0.7)pg/ml vs(15.2±0.6)pg/ml vs(15.6±0.5)pg/ml,P<0.001],OPG[(1131.6±49.9)pg/ml vs(1180.6±49.3)pg/ml vs(1443.8±42.3)pg/ml vs(1457.6±43.8)pg/ml,P<0.001],RANKL[(66.1±6.8)pg/mlvs(68.3±5.4)pg/ml vs(49.5±5.8)pg/ml vs(50.2±6.0)pg/ml,P<0.001],OPG/RANKL[(17.2±1.1)vs(17.3±0.7)vs(29.4±2.7)vs(29.3±2.6),P<0.001],with statistically significant differences between moderate and severe groups,and non-injury and mild groups.[Conclusion]Moderate and severe TBI do effectively promote callus growth and shorten fracture healing time,which may be related to the increase of se-rum CGRP concentration and OPG/RANKL expression ratio.