【摘要】 目的观察降钙素对脊柱植骨融合兔模型病理过程的影响。方法接受小关节突间植骨融合术后的32只雄性新西兰兔随机分为降钙素组和对照组。降钙素组的16只模型兔每日肌肉注射1IU·kg-1·d-1降钙素,对照组不给药。分别于术后第1、2、4和8周进行X线检查和标本采集。对标本进行HE和免疫组织化学染色观察植骨融合的病理过程和骨形态发生蛋白2(BMP2)的表达。结果植骨融合术后第1周以骨吸收和血痂形成为主;术后第2和4周可见较多软骨组织形成且矿化程度不均匀,软骨组织渐向骨组织过渡无明显界限;术后8周可见骨组织分布广泛。术后第4和8周降钙素组的组织学进程快于对照组;不同时间点Emery评分的差异具有显著性(F=265·44,P<0·001);降钙素与时间具有正协同作用,从第2周起降钙素能使Emery评分的差异具有显著性(F=22·43,P<0·001)。不同时间点BMP2表达的差异具有显著性(F=1186·54,P<0·001);时间和药物因素对促进BMP2的表达具有协同作用(F=13·14,P<0·001)。结论软骨内成骨是植骨融合过程的主要成骨形式,降钙素可能通过促进BMP2的表达使植骨融合加快。更多还原

【Abstract】 Objective To observe the effect of calcitonin on the pathology of fusion in lumbar posterior/facet spinal fusion in rabbit model. Methods Thirty-two male New Zealand white rabbits were used to establish spinal fusion model. Sixteen rabbits received calcitonin at a dose of 1 IU·kg~ -1 ·d~ -1 were classified as calcitonin group, and the remaining 16 rabbits as control group. Rabbits were killed 1,2,4,and 8 weeks after operations. Haematoxylin-eosin staining was applied to observe the pathological process of spinal fusion. Expression of bone morphogenetic protein-2(BMP_ 2 )was detected by immunohistochemistry. Results Bone resorption and fibrovascular stroma formation were the main histological presentation 1 week after surgery. Two and 4 weeks after surgery, more cartilage formed with varying degrees of mineralization, while less trabeculae could be observed in the phase of active bone formation. No remarked margin was seen between cartilage and bone tissues. Eight weeks after surgery, trabeculae distributed widely. The pathological process of spinal fusion in calcitonin group was faster than in control group. Emery scores showed significant differences at different time points(F=265.44,P<0.001). Calcitonin and time had a positively synergistic effect on Emery scores, and calcitonin caused significant difference in terms of Emery scores since the second week(F=22.43,P<0.001). Expressions of BMP_ 2 were significantly different at different time points(F=1186.54,P<0.001). Also, calcitonin and time had a synergistic effect on BMP_ 2 expression(F=13.14,P<0.001). Conclusions Endochondral ossification exists in the spinal fusion process and may be the main way of ossification. Calcitonin may stimulate the expression of BMP_ 2 and thus accelerate the process of spinal fusion.更多还原