【摘要】：【目的】 探討尼古丁對家兔脊柱融合模型的影響，闡明尼古丁的劑量與脊柱融合率的相關(guān)性。 【方法】 選擇60只6個(gè)月到8個(gè)月的成年健康家兔。按隨機(jī)對照原則將其分為4組，每組各15只。第1組為對照組；第2、3、4組為實(shí)驗(yàn)組。手術(shù)時(shí)，各組動(dòng)物用戊巴比妥鈉麻醉，麻醉成功后進(jìn)行后路切開L5-6雙側(cè)橫突后外側(cè)融合術(shù)(PLF)。第1組（對照組）術(shù)后第一天開始每天皮下注射生理鹽水1ml/kg/次，每天3次。第2、3、4組（實(shí)驗(yàn)組）術(shù)后第一天開始，各組每天皮下注射尼古丁分別為2mg/kg/次、4mg/kg/次、8mg/kg/次，每天3次。術(shù)后12周后處死家兔。截取L4-L7脊柱標(biāo)本，以手觸法測試、X片、CT掃描為手段評價(jià)融合情況。最后將已經(jīng)判定融合的標(biāo)本用自凝牙托粉制成力學(xué)試件，進(jìn)行生物力學(xué)測試。于每個(gè)試件施加前屈載荷，記錄位移-應(yīng)力曲線,當(dāng)試件斷裂時(shí)測最大位移。通過實(shí)驗(yàn)組與對照組對照，不同劑量尼古丁組間進(jìn)行對照，探討尼古丁對脊柱后外則橫突間融合手術(shù)融合率的影響。 【結(jié)果】 術(shù)后12周時(shí)，，手觸法判斷融合率，第1組為73.3%，第2組融合率為66.7%，第3組融合率為20.0%，第4組融合率為13.3%；X線判斷融合率，第1組為93.3%，第2組融合率為86.7%，第3組融合率為26.7%，第4組融合率為20.0%；CT線判斷融合率，第1組為80.0%，第2組融合率為66.7%，第3組融合率為33.3%，第4組融合率為26.7%。三種方法判斷融合率情況，第1組與第2組之間融合率差別無統(tǒng)計(jì)學(xué)意義（P0.05）。第1組與第3組、第1組與第4組之間融合率差別有統(tǒng)計(jì)學(xué)意義（P0.05），說明隨著尼古丁劑量的增加，對家兔脊柱融合有一定影響。生物力學(xué)測試結(jié)果顯示：①所有實(shí)驗(yàn)組，無論低劑量或高劑量尼古丁組與對照組（生理鹽水組）相比，差異均有統(tǒng)計(jì)學(xué)意義（P0.01）。②低劑量組（第2組）與中等劑量（第3組）和高劑量組（第4組）的差異均有統(tǒng)計(jì)學(xué)意義（P0.01）。③中等劑量（第3組）和高劑量組（第4組）的差異無統(tǒng)計(jì)學(xué)意義（P0.05）。 【結(jié)論】 手觸法檢測和影像學(xué)評估證明：低劑量尼古丁對脊柱融合無明顯影響，中等劑量和大劑量尼古丁阻礙了脊柱的融合； 生物力學(xué)研究表明：所有劑量的尼古丁均對腰椎后外側(cè)融合產(chǎn)生了影響，并且隨著尼古丁劑量的增加，脊柱融合率明顯下降。
[Abstract]:[objective] to investigate the effect of nicotine on spinal fusion model in rabbits. To elucidate the correlation between the dose of nicotine and spinal fusion rate. [methods] 60 adult healthy rabbits aged from 6 months to 8 months were selected. According to the principle of random control, they were divided into 4 groups with 15 rats in each group. The first group was the control group and the second group was the experimental group. During operation, the animals in each group were anesthetized with pentobarbital sodium. The posterior incision of L5-6 bilateral posterolateral fusion of the transverse process (PLF). Was performed after the anesthesia was successful. Group 1 (control group) received subcutaneous injection of normal saline 1ml/kg/ 3 times a day from the first day after operation. From the first day after operation, nicotine was injected subcutaneously to 2mg/kg/ 4 mg / kg / mg / kg, 3 times a day in the experimental group (experimental group). Rabbits were killed 12 weeks after operation. The spinal specimens of L4-L7 were cut off and the fusion was evaluated by X-ray CT scanning. Finally, biomechanical tests were carried out by using self-coagulating dental support powder to make the biomechanical specimens. The displacement-stress curve was recorded by applying forward bending load on each specimen, and the maximum displacement was measured when the specimen was broken. The effect of nicotine on the fusion rate of posterior lateral transverse process fusion was studied by the control group and the control group. [results] at 12 weeks after operation, the effect of nicotine on the fusion rate of spinal fusion was studied. The fusion rate was 73.3 in group 1, 66.7 in group 2, 20.0 in group 3, 13.3x ray in group 4, 93.3g in group 1, 86.7 in group 2, 26.7in group 3 and 20.0g in group 4. The fusion rate was 80.0 in the first group, 66.7 in the second group, 33.3 in the third group and 26.7in the fourth group. There was no significant difference in fusion rate between group 1 and group 2 (P0.05). The difference of fusion rate between group 1 and group 3, group 1 and group 4 was statistically significant (P0.05), which indicated that with the increase of nicotine dose, spinal fusion of rabbits was affected to some extent. The results of biomechanical tests showed that all experimental groups, whether low-dose or high-dose nicotine, were compared with the control group (saline group). The difference was statistically significant (P0.01) between the low dose group (group 2), the middle dose group (group 3) and the high dose group (group 4). There were significant differences between low dose group (P 0.01), middle dose group (group 3) and high dose group (group 4). [conclusion] the detection of hand contact and imaging evaluation showed that low dose nicotine had no significant effect on spinal fusion. Moderate and high doses of nicotine block spinal fusion; biomechanical studies show that all doses of nicotine have an effect on posterolateral lumbar fusion, and as nicotine doses increase, Spinal fusion rate decreased significantly.
【學(xué)位授予單位】：大理學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R687.3

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