本文選題：腦損傷 + 骨折��； 參考：《廣西醫(yī)科大學(xué)》2016年博士論文

【摘要】：目的：本文旨在探討B(tài)MP-4、5、6、7在腦損傷并骨折大鼠中的表達(dá)及意義,研究腦損傷促進(jìn)骨折愈合的機(jī)制,為骨折、骨折延遲愈合以及骨折不愈合的臨床治療提供一定的理論依據(jù)。方法：將SD大鼠110只,測量體重后采用隨機(jī)數(shù)字表隨機(jī)分成3組,A組為空白對(duì)照組10只,B組為單純脛骨骨折組50只,C組為腦損傷并骨折組50只,B組建立脛骨骨折模型,C組予以改良Feeney撞擊器建立中度腦損傷并骨折模型。觀察兩組大鼠的一般狀態(tài),包括動(dòng)物體重,精神狀態(tài),大小便情況,活動(dòng)情況,進(jìn)食量,飲水量等；腦組織損傷情況,實(shí)驗(yàn)后第1、2、3、5、7周取C組動(dòng)物腦組織,行組織病理切片后行HE染色,在光學(xué)顯微鏡下觀察受損腦組織不同時(shí)間段的變化情況；骨折的線表現(xiàn)：術(shù)后第1、2、3、5、7周對(duì)B組和C組拍攝正側(cè)位X片了解骨折愈合情況,以BI一2000醫(yī)學(xué)圖像分析系統(tǒng)分析骨痂的灰度值；觀察骨痂大小,從膝關(guān)節(jié)處離斷手術(shù)側(cè)脛骨,以游標(biāo)卡尺測量骨痂的最大長度；骨痂的組織學(xué)觀察,取出骨痂,組織切片HE染色觀察骨折局部血腫、骨痂組織結(jié)構(gòu)變化等。分別于1、2、3、5、7周測量大鼠血清和骨痂中BMP-4、5、6、7基因的mRNA水平以及蛋白含量。統(tǒng)計(jì)分析所得數(shù)據(jù)。結(jié)果：觀察到腦損傷并骨折組大鼠在第2周開始活動(dòng)逐漸增多,第4周左右基本恢復(fù)正常活動(dòng),早于單純骨折組的第5周；腦損傷的組織學(xué)發(fā)現(xiàn)：早期腦組織損傷出血,繼而出現(xiàn)空洞、壞死；骨折的X線檢查發(fā)現(xiàn)腦損傷并骨折組2周折端有骨痂生長,3周可見大量骨痂生長,骨折線模糊；5周、7周骨折端大量骨痂生長,骨折線基本消失,骨痂出現(xiàn)時(shí)間早于單純骨折組,在第2、3、5、7周骨痂灰度高于單純骨折組(P0.05)；骨痂直徑測量發(fā)現(xiàn)腦損傷并骨折組的骨痂直徑明顯大于單純骨折組(P0.05)；骨痂的組織學(xué)觀察到腦損傷并骨折組早期出現(xiàn)大量新生血管以及骨小梁,骨痂形成以及骨痂塑形早于單純骨折組；兩組大鼠的血清BMP-4、6、7基因的mRNA均呈高水平表達(dá)(P0.05),隨時(shí)間變化,而血清BMP-5基因的mRNA則未見異常表達(dá),且腦損傷并骨折組血清及骨痂中的BMP-4、6、7蛋白含量mRNA表達(dá)水平高于單純骨折組(P0.05)；兩組大鼠的血清BMP-4、6、7蛋白含量高(P0.05),隨時(shí)間變化,而血清BMP-5蛋白含量未見異常,且腦損傷并骨折組血清及骨痂中的BMP-4、6、7蛋白含量高于單純骨折組(P0.05)。結(jié)論：1：在中度腦損傷的大鼠動(dòng)物模型中骨痂形成時(shí)間早,數(shù)量多,骨折的愈合早,說明腦損傷可能會(huì)通過骨形成蛋白調(diào)控骨痂的形成,進(jìn)而加速骨折愈合。2：在中度腦損傷的大鼠動(dòng)物模型中血清和骨痂的骨形態(tài)發(fā)生蛋白mRNA和蛋白的表達(dá)水平存在差異,其中BMP-4、6、7的mRNA和蛋白表達(dá)水平較高,可能促進(jìn)骨折的愈合,而BMP-5的mRNA和蛋白表達(dá)水平較低,可能對(duì)進(jìn)骨折的愈合影響不大。3：動(dòng)物模型中血清和骨痂的骨形態(tài)發(fā)生蛋白的mRNA的表達(dá)與蛋白表達(dá)相一致,說明多種骨形態(tài)發(fā)生蛋白在基因的轉(zhuǎn)錄和翻譯過程中的調(diào)控機(jī)制可能相似。
[Abstract]:Objective : To investigate the expression and significance of BMP - 4 , 5 , 6 and 7 in brain injury and fracture rats .
The brain tissue was injured by HE staining at the 1st , 2nd , 3rd , 5th and 7th weeks after the experiment , and the changes of the injured brain tissue were observed under the optical microscope .
The line manifestations of fracture were as follows : 1 , 2 , 3 , 5 , 7 weeks after operation , positive side X - ray films were taken to understand fracture healing in group B and group C , and the gray value of callus was analyzed by BI - 2000 medical image analysis ;
The size of callus was observed , the tibia was separated from the knee joint and the maximum length of callus was measured with vernier caliper ;
The expression of BMP - 4 , 5 , 6 , 7 mRNA and protein content in serum and callus of rats were measured at 1 , 2 , 3 , 5 and 7 weeks . The results showed that the activity of BMP - 4 , 5 , 6 , 7 genes increased gradually in the second week after injury of brain injury and fracture group .
Histological findings of brain injury revealed that early brain tissue damaged hemorrhage , followed by cavitation and necrosis .
X - ray examination revealed that there was callus growth in 2 weeks of fracture group , and a large number of callus growth was seen in 3 weeks , and the fracture line was blurred ;
After 5 weeks , 7 weeks fracture end mass callus growth , fracture line basically disappeared , callus appeared earlier than simple fracture group , in the 2nd , 3rd , 5th , 7th week the callus gray level was higher than simple fracture group ( P0.05 ) ;
The diameter of callus was found to be significantly larger than that of simple fracture group ( P0.05 ) .
The histological observation of callus showed that there appeared a large number of new blood vessels in the early stage of the brain injury and early fracture group , the formation of callus and the formation of callus were earlier than that of simple fracture group .
The levels of BMP - 4 , 6 , 7 mRNA in serum of both groups were higher than those in simple fracture group ( P0.05 ) .
The bone morphogenetic protein ( BMP - 4 , 6 , 7 ) content of bone morphogenetic protein ( BMP - 4 , 6 , 7 ) was higher than that in simple fracture group ( P0.05 ) . Conclusion : 1 : The expression level of BMP - 4 , 6 , 7 in the rat model of moderate brain injury is higher than that in simple fracture group ( P0.05 ) .
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2016
【分類號(hào)】：R651.15;R683

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