糖尿病对大鼠骨折愈合影响的实验研究

目的:观察糖尿病大鼠的骨折愈合过程,探讨糖尿病影响大鼠骨折愈合的可能的机制,为临床实践提供理论依据。方法:雄性Wister大鼠140只,随机分成二组,每组70只,A组为糖尿病骨折组;B组为非糖尿病骨折组。建立糖尿病动物模型后,无菌条件下在各组大鼠胫骨中点用手术方法制成骨折模型。术后1周、2周、4周、6周、8周各时间点进行X线检查,观察骨折愈合情况。术后1周、2周、3周、4周、6周、8周分别用ELISA法检测血清中IGF-1含量。分别在1、2、4、6、8周各时间点观察5只大鼠骨痂生长情况并取骨折断端组织行HE染色光镜观察。术后4周、6周、8周每组处死10只大鼠留取双侧胫骨标本,冷冻保存后集中进行生物力学检测。结果:1、大体标本观察结果:各时间点A组骨痂生长减缓延迟。2、X线结果:A组骨折愈合质量在各时间点均明显低于B组。3、生物力学测定结果:4周、6周、8周个时间点A组骨折处骨痂的机械强度均明显低于B组。4、组织学染色显示:术后各时间点1、2、4、6、8周A组与B组相比骨折处局部骨痂成熟延迟并且软骨细胞肥大。5、血清IGF-1含量测定:A组大鼠血清中IGF-1含量低于B组,且高峰延迟1周。结论:1.患有糖尿病后大鼠骨折愈合质量差,比较容易出现愈合延迟甚至不愈合;2.患有糖尿病的大鼠骨折后血清中的IGF-1表达明显低于对照组,且高峰推迟1周。

The Experimental Study on the Effects of Diabetes to Rat Fracture

Objective: To observe the process of fracture healing in diabetic rats.Then to investigate the possible factors related to frature healing in diabetic rats.Methods: 140 male Wister rats were randomly divided into two groups.Group A was Diabetes group,Group B was control group.Fracture model was made in tibial and then reducted and internal fixed.The X-rays of tibial taken in the two groups in 1th,2th,4th,6th,8th week after the surgery to evaluation the fractue healing.After 1,2,3,4,6,8 weeks operation the serum IGF-1 was examined by ELISA assay.1,2,4,6,8 weeks after fracture,5 rats were sacrificed in each group to observe the growth of callus,the tissue of fracture region was taken for HE staining.At 4th,6th and 8th week after operation biomechanical test was done.Results: An-tomic observation showed that every time point group A callus growth was slower.There were more periosteal reaction and rapid bone reconstruction in group B than in group A.The diabetic callus mechanical strength was significantly lower than that in control group.HE staining suggested the chondrocyte maturation hysteresis and hypertrophy in diabetic rats.Serum IGF-1 level were significantly decreased and the peak was delayed for one week in dabetic rats.Conclusion: The diabete mellitus severely affected the rat fracture healing,and the delayed and non-union occurace was significantly increased.The level of expression of IGF-1 in serum was decreased and peak was de-layed in diabetic rats.