中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (2): 162-166.doi: 10.3969/j.issn.2095-4344.2016.02.002

• 骨组织构建 bone tissue construction • 上一篇    下一篇

Ⅰ型胶原N末端肽和定量CT骨密度早期测定实验性骨不连

林坚平1，2，沈宁江1，史占军2，王 健2，肖 军2，吴多能1，张 武1   

  1. 1海南省人民医院关节外科，海南省海口市 570311；2南方医科大学南方医院关节外科，广东省广州市 510515
  • 收稿日期:2015-11-11 出版日期:2016-01-08 发布日期:2016-01-08
  • 作者简介:林坚平，男，1971年生，海南省儋州市人，汉族，在读博士，布加勒斯特大学医院访问学者，主任医师，主要从事骨愈合，生物骨，人工关节研究。
  • 基金资助:
    海南省自然科学基金资助课题(808212)

Early diagnosis of experimental bone nonunion: measurement of N-terminal telopeptide of type I collagen and quantitative CT determination of bone mineral density

Lin Jian-ping1, 2, Shen Ning-jiang1, Shi Zhan-jun2, Wang Jian2, Xiao Jun2, Wu Duo-neng1, Zhang Wu1   

  1. 1Department of Joint Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China; 2Department of Joint Surgery, Nanfang Hospital of South Medical University, Guangzhou 510515, Guangdong Province, China
  • Received:2015-11-11 Online:2016-01-08 Published:2016-01-08
  • About author:Lin Jian-ping, Studying for doctorate, Chief physician, Department of Joint Surgery, Hainan General Hospital, Haikou 570311, Hainan Province, China; Department of Joint Surgery, Nanfang Hospital of South Medical University, Guangzhou 510515, Guangdong Province, China
  • Supported by:

    the Natural Science Foundation of Hainan Province, No. 808212

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被引次数

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摘要：

文章快速阅读：

 

文题释义：
定量CT测量法：利用CT的较高密度分辨率测量骨密度，以骨旁肌肉和脂肪组织做为内参考标准，去除了对外部体模的需求，去除了因人工制造的外部体模的非均一性及体模与被测体相对位置变化对测量结果的影响，改进了测量的准确度和精确性。

定量CT检测的优势：在测量骨密度的同时可以观测骨的微结构，包括骨容积率、骨表面积率、骨小梁厚度、骨小梁间隔、肾小梁长度、连接密度、结构模型参数等。

 

背景：目前主要通过传统的X射线诊断骨折不愈合，这种方法仅依赖于临床医师的经验和骨折愈合中骨痂的矿化程度，易受投照、冲洗条件及主观因素影响，精确度欠佳。
目的：建立骨折不愈合动物模型，检测其生化指标及骨密度变化规律。
方法：将20只新西兰大白兔随机均分为2组，分别在前臂桡骨中段制作骨缺损模型与骨折模型，分别于术前、术后2，3，4，5，6，7，8，10，12周进行前臂的X射线检查、定量CT骨密度测定及血清学检测。

结果与结论：X射线显示，骨缺损组中3只兔于术后第2周有少许骨痂形成，但5周后骨痂情况稳定，术后8周仍无愈合；骨折组术后2周开始骨折线模糊，术后6-8周骨痂大量生长。骨缺损组术后5周开始骨密度值明显下降，与骨折组比较差异显著。血清学检测显示，骨缺损组术后骨特异性碱性磷酸酶活性升高，第4周达到高峰，第5周时出现下降，第6周以后数值基本稳定；骨缺损组术后抗酒石酸酸性磷酸酶5b 活性升高，在第4周出现峰值，然后下降，基本稳定；骨缺损组Ⅰ型胶原N末端肽在术后5周出现明显下降，术后6周以后基本稳定。说明系统性监测骨密度及生化指标如骨特异性碱性磷酸酶、抗酒石酸酸性磷酸酶5b 和Ⅰ型胶原N末端肽的变化可能有助于反映兔骨折不愈合早期进程。 

 ORCID: 0000-0002-6059-6390(林坚平)

关键词: 组织构建, 骨组织工程, 骨不连, 生物标志物, 抗酒石酸酸性磷酸酶5b, Ⅰ型胶原N末端肽, 骨特异性碱性磷酸酶, ELISA, 海南省自然科学基金　

Abstract:

BACKGROUND: Currently, X-ray examination is mainly used for diagnosis of nonunion. However, this method that relies only on the clinician’s experience and degree of callus mineralization has less accuracy because it is vulnerable to projection, processing conditions and subjective factors.
OBJECTIVE: To establish an animal model of nonunion and to detect the variation of biochemical markers and bone mineral density.
 
METHODS: Twenty New Zealand white rabbits were randomly divided into two groups, and bone defect and fracture models were made in the midshaft of the forearm radius, respectively. X-ray examination of the forearm, quantitative CT measurement of bone mineral density and serological test were carried out before and at 2, 3, 4, 5, 6, 7, 8, 10, 12 weeks after surgery.
RESULTS AND CONCLUSION: Postoperative X-ray films showed that the in the bone defect group, a little callus formed in three rabbits at 2 weeks, the callus formed stably at 5 weeks, but there was still no healing at 8 weeks; in the fracture group, the fracture line was blurred at 2 weeks and a large number of calluses formed at 6-8 weeks. Compared with the fracture group, the value of bone mineral density in the bone defect group began to decrease significantly at 5 weeks after surgery. Results from the serological test showed that in the bone defect group, the activity of bone-specific alkaline phosphatase increased after surgery, reached peak at 4 weeks, began to decrease at 5 weeks and became stable at 6 weeks; the activity of tartrate-resistant acid phosphatase 5b increased after surgery, peaked at 4 weeks, then decreased and stabilized basically; the expression of N-terminal telopeptide of type I collagen decreased significantly at 5 weeks after surgery and became stable at 6 weeks. These findings indicate that the systematic monitoring of changes in bone mineral density and biochemical indicators such as bone-specific alkaline phosphatase, tartrate-resistant acid phosphatase 5b and type I collagen N-terminal telopeptides may help to reflect the early progress of rabbit nonunion.