【作者】 郝永强； 戴尅戎；

【Author】 HAO Yong-qiang, DAI Ke-rong. Department of Orthopaedics, the Ninth People’s Hospital, Shanghai Second Medical University, Shanghai 200011,China

【机构】 上海第二医科大学附属第九人民医院骨科；

【摘要】 目的:观察骨质疏松性骨折愈合过程中的细胞超微结构改变,阐明骨质疏松性骨折的细胞学愈合机制。方法:8月龄雌性SD大鼠80只,体重290-340 g,随机分为骨质疏松性骨折模型组(OPFM)与一般性骨折模型组(CFM),每组40只,麻醉后,OPFM组经双侧腰背侧切口进入腹腔,行双侧卵巢切除;CFM组行腰背部伪手术。术后3个月,两组均经股外侧切口切断股骨中段后行克氏针髓腔逆行内固定,建立骨质疏松性骨折与一般性骨折实验模型,实验模型建立后分别于第5 d、1、2、4、6、8、12、16周每组各处死4只动物,于骨痂外取2mm×2mm 组织(含连接骨痂与外骨痂),分别进行透射与扫描电镜观察。结果:透射电镜观察显示,OPFM 组与CFM组相比软骨细胞数目较多,但功能较低,分泌的胶原纤维数量低且排列紊乱;成骨细胞数目与功能状态均降低,胞周分泌的胶原纤丝稀疏、紊乱;破骨细胞功能状态活跃。扫描电镜观察显示,CFM组与OPFM组相比,胶原纤维致密,排列方向较为规则。结论:骨质疏松性骨折愈合时,成骨细胞的成骨能力降低,破骨细胞的骨吸收能力增强,骨折愈合质量差。更多还原

【Abstract】 Objective To observe the ultrastructural alteration and healing characteristics of osteoporotic fracture, and to elucidate its cellular mode of healing. Methods Eighty female SD rats of 8 months old, which had the weight of 290 to 340 g, were randomized into two groups of 40 each: the osteoporotic fracture model (OPFM) and the common fracture model (CFM) . After anesthesia,the bilateral posterior transperitoneal approach was performed in the OPFM group and the bilateral ovaries were removed; and in the CFM group, only the sham operations were performed. Three months later, the fracture of femoral middle shaft were created and fixed with a Kirschner pin through medullary cavity. The callus of each rat was examined by transmission electron microscopy (TEM) and scanning electron microscopy (SEM) in 5 days and 1,2,4, 6, 8, 12 and 16 weeks postoperatively. Results TEM showed that the number of chondrocyte in OPFM group was greater, but function was lower than that of CFM group. Volume of collagen secreted by the chondrocyte was less and arranged irregularly during the fracturehealing period in OPFM group. Number and function of osteoblasts in OPFM group were lower than that of CFM group. Extracellular collagen was disordered and sparse, but function of osteoclasts in OPFM group was more active than that of CFM group. The SEM showed that the collagen in callus of CFM group was dense and arranged in good order or pyknotic. Conclusion The fracture healing of the osteoporotic fractures is due to the decrease of the osteoblastic formation and the increase of the osteoclastic resorption as well as the poor bony healing quality.更多还原