本文選題：糖尿病　切入點(diǎn)：骨質(zhì)疏松　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:2型糖尿病好發(fā)于老年群體,其并發(fā)癥糖尿病骨質(zhì)疏松給老年患者帶來(lái)了嚴(yán)重的危害[1]。老年群體中,牙缺失的現(xiàn)象非常常見(jiàn)。對(duì)于這一類病人,牙種植是一種重要的治療方式。然而,糖尿病骨質(zhì)疏松對(duì)老年患者牙種植的穩(wěn)定性造成了嚴(yán)重影響。本實(shí)驗(yàn)的目的為如何提高糖尿病骨質(zhì)疏松患者種植周的骨整合。方法:60只雄性SD大鼠適應(yīng)性喂養(yǎng)1周,隨機(jī)分為三組:1)正常組;2)2型糖尿組;3)糖尿病+雙磷酸鹽(Bisphosphonates,BPs)組。均在所有大鼠的雙側(cè)股骨頭植入種植釘。組1)和組2)的大鼠在種植釘置入種植窩前于種植窩內(nèi)注入不含BPs的凝膠,組3)的大鼠于種植窩內(nèi)注入含有BPs的凝膠。分別于種植體植入后4w和8w處死各組大鼠,取股骨進(jìn)行相關(guān)檢測(cè)。運(yùn)用熒光雙標(biāo)法檢測(cè)種植體周?chē)堑V化沉積率(MAR),Micro-CT檢測(cè)骨體積率(BV/TV),骨小梁厚度(Tb.Th),骨小梁數(shù)量(Tb.N),骨小梁間距(Tb,Sp),組織形態(tài)學(xué)法檢測(cè)種植體周?chē)墓欠植悸?BA)和骨表面接觸率(BIC),同時(shí)運(yùn)用最大推力和最大剪切力兩種生物力學(xué)實(shí)驗(yàn)來(lái)評(píng)價(jià)骨質(zhì)量。通過(guò)BMSCs在高糖環(huán)境下的成骨分化情況,檢測(cè)ALP染色,Runx2及Osterix的m RNA的表達(dá),以及Runx2和OC的基因表達(dá),從而判斷高糖環(huán)境下BPs介導(dǎo)的BMSCs的成骨能力。結(jié)果:和糖尿病組相比,正常組和糖尿病+雙磷酸鹽組大鼠種植體周?chē)墓堑V沉積率(MAR)增加,組織形態(tài)學(xué)檢測(cè)結(jié)果顯示BA和BIC增加,Micro-CT檢測(cè)結(jié)果顯示BV/TV,Tb.Th,Tb.N升高而Tb,Sp降低,生物力學(xué)檢測(cè)結(jié)果顯示最大推力實(shí)驗(yàn)和最大剪切力均增加。體外實(shí)驗(yàn)結(jié)果顯示高糖抑制了BMSCs的成骨分化,而B(niǎo)Ps可以在一定程度減輕這種抑制效應(yīng)。結(jié)論:糖尿病骨質(zhì)疏松對(duì)牙種植體的穩(wěn)定性具有不利影響。局部小劑量運(yùn)用雙磷酸鹽對(duì)糖尿病骨質(zhì)疏松患者的種植體骨整合具有有利作用。
[Abstract]:Objective to study the prevalence of type 2 diabetes mellitus in the elderly population. The complications of diabetes mellitus osteoporosis bring serious harm to the elderly patients [1] .Tooth loss is very common in the elderly population. Dental implants are an important treatment. However, The aim of this study was to improve the bone integration in the implants of diabetic osteoporosis patients. Methods 60 male Sprague-Dawley rats were fed adaptively for one week. The rats were randomly divided into three groups: normal group (n = 1), normal group (n = 3), bisphosphate bisphosphate bisphosphate group (n = 3). All rats were implanted in bilateral femoral head of rats. Group 1) and group 2) rats were injected with BPs free gel in implant fossa before the implantation of implant nail. Rats in group 3 were injected with gel containing BPs in the implant fossa. The rats in each group were killed at 4 weeks and 8 weeks after implantation, respectively. Bone mineral deposition rate around implants and bone volume ratio (BV / TVV), bone trabecular thickness (Tb. Thn), trabecular number (TB. Nu), bone trabecular spacing (TbN), bone trabecular spacing (TbN), and histopathology were detected by fluorescence double labeling method (BV / TVV) and bone trabecular thickness (Tb 路Th), bone trabecular spacing (TbN), and histomorphology (histomorphology) of bone around implants. Bone distribution rate (BAA) and bone surface contact rate (BMSCs) were used to evaluate the bone mass by using two biomechanical experiments, maximum thrust and maximum shear force. The expression of m RNA in Runx2 and Osterix and the gene expression of Runx2 and OC in ALP staining were detected to determine the osteogenic ability of BMSCs mediated by BPs in high glucose environment. The bone mineral deposition rate around implants was increased in normal group and diabetic bisphosphate group. Histomorphologic examination showed that BA and BIC increased and Micro-CT showed that BV / TVT Tb. Thn increased and TbSp decreased. The results of biomechanical test showed that both the maximum thrust test and the maximum shear force were increased. In vitro, high glucose inhibited the osteogenic differentiation of BMSCs. Conclusion: diabetic osteoporosis has adverse effects on the stability of dental implants. Local small dose of bisphosphate on implant bone in diabetic patients with osteoporosis. Integration is beneficial.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R783.6

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本文編號(hào)：1605020