浓缩自体骨髓移植结合金葡液局部注射对骨质疏松性骨折愈合过程中BMP-2和VEGF表达的调控

摘要

[目的]探讨浓缩自体骨髓移植结合金葡液注射治疗骨质疏松性骨折的疗效及其可能的分子机理。[方法]5月龄雌性家兔80只，体重2.5~3.0kg，采用去势法建造OPF动物模型，随机分成4组。分别为浓缩自体骨髓移植结合金葡液局部注射治疗组（A组）、浓缩自体骨髓移植治疗组（B组）、金葡液局部注射治疗组（C组）、未治疗组（D组），每组20只。分四个时间点（2W、4W、6W、8W）处死动物取材，进行X线摄片、测定骨痂CT值、BMP-2及VEGF染色阳性细胞计数观察。[结果]各取材时间A组X线表现明显优于其它三组，A组第8W时骨折线基本消失。CT值对比显示各组CT值呈递增趋势，A组递增幅度最大，D组递增幅度最小，同一时间点取材各组骨痂CT值比较发现A组骨痂CT值均高于其它组（P<0.01）。HE染色显示A组在2、4W时软骨细胞、成骨细胞较多，6、8W取材时可见细胞都已经成熟；D组第8W时仍较多软骨细胞存在。免疫组化结果显示2W时A组骨痂细胞中BMP-2、VEGF的表达量均高于其它组；第8W时A、B、C组表达量均极少，D组表达量高于前3组。[结论]浓缩自体骨髓移植结合金葡液局部注射能促进骨质疏松性骨折愈合，其作用明显优于单纯应用骨髓移植治疗或单纯金葡液局部注射治疗，其机理可能是提高了骨折早中期BMP-2和VEGF的表达。%[Objective]Explore the effect of concentrated autologous bone marrow implanted and local injection with Staphylococcal Enterotoxin C Injec-tion and its possible biological mechanism in treating osteoporotic fracture(OPF).[Methods] A total of 80 female rabbits,5-month-old,weighing 2.5~3.0 kg, were subjective to ovary resection to establish osteoporotic fracture(OPF) model, and were randomly divided into 4 groups, concentrated autologous bone marrow implanted and local injection with Staphylococcal Enterotoxin C Injection group(group A), concentrated autologous bone marrow implanted group(group B), local injection with Staphylococcal Enterotoxin C Injection group(group C), no treatment group(group D),with 20 rabbits in each group. Observe bones through X-ray, CT value and calculate BMP-2 and VEGF positive cells after the rabbits were sacrificed in 2, 4 , 6 and 8 weeks. [Results] X-ray indicated fracture line of group A faded more quickly than other 3 groups and disappeared in 8 weeks. CT value of cal us in each group gradual y increased in different time,especial y in group A and the smal est account in group D.But in the same time, CT value of cal us of group A was obviously higher than that of other groups(P<0.01). HE demonstrated that there were many chondrocytes and osteoblasts in 2 and 4 weeks,which grew mature in 6 and 8 weeks, however group D stil had more chondrocyte in 8 weeks.SABC displayed the expression of BMP-2 and VEGF of cal us cells in group A was higher than other three groups in 2 weeks; but that of group D was the highest in 8 weeks,which had fewer expression in groups A,B and C. [Con-clusion] Concentrated autologous bone marrow implanted combining with local injection of Staphylococcal Enterotoxin C can speed up the healing of OPF,its effect is obviously better than that of either method. Its possible biological mechanism is increasing the expression of BMP-2 and VEGF of cal us cells in early and middle periods.