不同程度大鼠颅脑损伤股骨骨折骨愈合比较△

Comparison of bone healing of femoral fracture in rats with different extents of craniocerebral injury

摘要:

[目的] 探究大鼠不同程度创伤性颅脑损伤（traumatic brain injury, TBI） 合并单侧股骨骨折愈合的影响，以及降钙素基因相关肽（calcitonin gene-related peptide, CGRP） 及骨保护素（osteoprotegerin, OPG） /核因子κB 受体活化因子配体（receptoractivator of nuclear factor-κB ligand, RANKL） 在其中的作用。[方法] 80 只雄性11 周龄大鼠随机分为4 组，每组20 只，按照神经功能缺损评分（neurological severity score, NSS） 标准建立模型，分为单纯股骨骨折（无损伤组）、轻度TBI 合并股骨骨折（轻度组）、中度TBI 合并股骨骨折（中度组）、重度TBI 合并股骨骨折（重度组）。比较骨折愈合情况及血清检测结果。[结果] 无损伤组、轻度组、中度组和重度组术后6 周骨折愈合X 线评分为[(1.0±0.7) vs (1.0±0.7) vs (1.8±0.5) vs (1.8±0.5), P＜0.001]，骨痂体积为[(418.6±25.7) mm³ vs (414.3±29.6) mm³ vs (689.8±31.2) mm³ vs (681.4±31.8) mm³, P＜0.001]，其中度组和重度组显著高于无损伤组和轻度组。血清检测方面，无损伤组、轻度组、中度组和重度组术后6 周的CGRP [(10.9±0.9) pg/ml vs (11.1±0.7) pg/ml vs(15.2±0.6) pg/ml vs (15.6±0.5) pg/ml, P＜0.001]、OPG [(1 131.6±49.9) pg/ml vs (1 180.6±49.3) pg/ml vs (1 443.8±42.3) pg/ml vs (1 457.6±43.8) pg/ml, P＜0.001]、RANKL [(66.1±6.8) pg/ml vs (68.3±5.4) pg/ml vs (49.5±5.8) pg/ml vs (50.2±6.0) pg/ml, P＜0.001]、OPG/RANKL[(17.2±1.1) vs (17.3±0.7) vs (29.4±2.7) vs (29.3±2.6), P＜0.001]，上述指标，中度组和重度组与无损伤组和轻度组之间差异均有统计学意义。[结论] 中、重度组可以有效促进骨折端骨痂生长，缩短骨折愈合时间，这可能与血清中CGRP 浓度与OPG/RANKL表达比值升高有关。

Abstract:

[Objective] To investigate the effects of traumatic brain injury (TBI) on unilateral femoral fracture healing in rats in termsof calcitonin gene-related peptide (CGRP), and osteoprotegerin (OPG) / receptor activator of nuclear factor-κB ligand (RANKL). [Meth-ods] A total of 80 11-week-old male rats were randomly divided into 4 groups with 20 rats in each group. A model was established accord-ing to neurological severity score (NSS) and the rats were divided into simple femoral fracture (non-injury group) and mild TBI combinedwith femoral fracture (mild group), moderate TBI with femur fracture (moderate group), and severe TBI with femur fracture (severe group).The data of fracture healing and serum assays were compared. [Results] The noninjury group, mild group, moderate and severe groupwere measured X-ray score [(1.0±0.7) vs (1.0±0.7) vs (1.8±0.5) vs (1.8±0.5), P＜0.001] and callus volume [(418.6±25.7) mm³ vs (414.3±29.6)mm3 vs (689.8±31.2) mm³ vs (681.4±31.8) mm³, P＜0.001] 6 weeks after operation, of which the moderate and severe groups were significant-ly higher than the non-injury and mild groups. Regarding to serum assay, the non-injury group, mild group, moderate group and severegroup at 6 weeks after surgery were assayed CGRP [(10.9±0.9) pg/ml vs (11.1±0.7) pg/ml vs (15.2±0.6) pg/ml vs (15.6±0.5) pg/ml, P＜0.001],OPG [(1 131.6±49.9) pg/ml vs (1 180.6±49.3) pg/ml vs (1 443.8±42.3) pg/ml vs (1 457.6±43.8) pg/ml, P＜0.001], RANKL [(66.1±6.8) pg/mlvs (68.3±5.4) pg/ml vs (49.5±5.8) pg/ml vs (50.2±6.0) pg/ml, P＜0.001], OPG/RANKL [(17.2±1.1) vs (17.3±0.7) vs (29.4±2.7) vs (29.3±2.6),P<0.001], with statistically significant differences between moderate and severe groups, and non-injury and mild groups. [Conclusion]

Moderate and severe TBI do effectively promote callus growth and shorten fracture healing time, which may be related to the increase of se-

rum CGRP concentration and OPG/RANKL expression ratio.