骨形态发生蛋白2在人骨不连组织中的表达及其临床意义

Expression of bone morphogenetic protein 2 in human nonunion tissue and the clinical significance

目的:探讨肥大性骨不连组织与萎缩性骨不连组织在成骨潜能上的差异,进一步指导骨不连的治疗。方法:收集2010年10月至2014年3月入住中南大学湘雅二医院骨科的骨不连患者骨不连处组织40例,按照骨不连性质分为肥大性骨不连组(n=20)、萎缩性骨不连组(n=20);按照不同年龄段分为20~35岁年龄组(n=18)、36~50岁年龄组(n=18)、>50岁年龄组(n=4);按照骨不连时间分为9~12个月组(n=21)、13~24个月组(n=14)和>24个月组(n=5)。利用免疫组织化学SP二步法及IPP6.0病理图像分析软件对骨不连组织中骨形态发生蛋白-2(bone morphogenetic protein-2,BMP-2)的表达进行半定量分析,测定其平均吸光度值。结果:肥大性骨不连组BMP-2平均吸光度值为0.1540±0.0408,萎缩性骨不连组BMP-2平均吸光度值为0.1372±0.0372,两组标本BMP-2平均吸光度值差异无明显统计学意义(P>0.05)。20~35岁年龄组BMP-2平均吸光度值为0.1477±0.0379,36~50岁年龄组BMP-2平均吸光度值为0.1419±0.0399,>50岁年龄组BMP-2平均吸光度值为0.1456±0.0595,三组年龄段标本间BMP-2平均吸光度值差异无明显统计学意义(P>0.05)。在三组不同骨不连时间中,9~12个月组BMP-2的平均吸光度值为0.1449±0.0366,13~24个月组BMP-2的平均吸光度值为0.1472±0.0400,>24个月组BMP-2的平均吸光度值为0.1445±0.0541,三组不同骨不连时间标本之间BMP-2平均吸光度值差异亦无明显统计学意义(P>0.05)。结论:肥大性骨不连组织和萎缩性骨不连组织在成骨潜能上无显著性差异。

Objective:To explore the difference of bone formation potential between hypertrophic nonunion tissue and atrophic nonunion tissue,which may be beneficial to nonunion therapy.Methods:From October 2010 to March 2014,40 nonunion tissue samples were collected in Department of Orthopedics,Second Xiangya Hospital.The samples were divided into a hypertrophic nonunion group(n=20) and an atrophic nonunion group(n=20) according to nonunion character;or a 20 to 35 years old group(n=18),a 36 to 50 years old group(n=18),a more than 50 years old group(n=4) according to different ages;or a 9-12 months group(n=21),13-24 months group(n=14) and a more than 24 months group(n=5) according to different nonunion time.Semi-quantification was performed by SP immunohistochemical method and IPP6.0 was used to analyze the expression of bone morphogenetic protein-2(BMP-2) through measuring the mean optical density.Results:The mean optical density of BMP-2 was 0.1540±0.0408 in hypertrophic nonunion tissue,0.1372±0.0372 in atrophic nonunion tissue,there was no significant difference between the 2groups(P>0.05).The mean optical density of BMP-2 was 0.1477±0.0379 in the 20 to 35 years old group,0.1419±0.0399 in the 35 to 50 years old group,0.1456±0.0595 in the more than 50 years old group,there was no significant difference among the three groups(P>0.05).The mean optical density of BMP-2 was 0.1449±0.0366 in the 9-12 months group,0.1472±0.0400 in the13-24 months group,0.1445±0.0541 in the more than 24 months group,there was no significant difference among the 3 groups(P>0.05).Conclusion:The present results suggest that the hypertrophic nonunion tissue share similar osteogenic potential with the atrophic nonunion tissue.