本文選題：硫酸鈣 + 鍶元素　； 參考：《川北醫(yī)學院》2015年碩士論文

【摘要】：目的:觀察摻鍶硫酸鈣局部植入對兔股骨髁部骨缺損的修復作用,并探討修復過程中機體血液流變學的改變。方法:將48只新西蘭兔股骨髁部進行骨缺損造模后,隨機分為摻鍶硫酸鈣組(研究組)、半水硫酸鈣組(對照組)與模型組。研究組在骨缺損局部植入(Sr Cl2的摩爾比例為0.5%)摻鍶硫酸鈣修復材料;對照組骨缺損區(qū)域植入半水硫酸鈣修復材料;模型組則缺損部位曠置。術后4、12w進行CT影像學檢測,觀察骨缺損的修復情況,并進行新骨影像學評分。術后8、12 w處死動物,取股骨下段,對股骨遠端的骨缺損區(qū)進行壓凹實驗。術后2、4 w分別利用茜素紅S與鈣黃綠素進行熒光標記,并于術后8w取標本進行組織形態(tài)學觀察。術前及術后2、8、12 w耳緣靜脈采血,測定生化指標與血液流變學指標。結果:實驗動物骨缺損造模后,與手術前比較,血清中的堿性磷酸酶(ALP)均顯著性升高(P0.05);術后2 w,研究組的ALP顯著高于模型組與對照組(P0.05),其他生化指標包括谷草轉(zhuǎn)氨酶、谷丙轉(zhuǎn)氨酶、尿素氮、肌酐、尿酸未見顯著性差異(P0.05)。CT掃描結果顯示,術后12 w,研究組的骨缺損局部區(qū)域被新生骨組織充滿,其密度與正常骨組織幾乎一樣,對照組12 w時,骨缺損局部仍可見少量植入材料的碎片。術后4 w,研究組的新骨形成的影像學評分高于對照組(P0.05)。術后8 w和12 w,研究組的股骨髁骨缺損區(qū)壓縮強度均高于對照組(P0.05)。形態(tài)學研究結果顯示,術后2 w,研究組的骨生成顯著高于對照組(P0.01);術后4 w,研究組的骨礦化顯著優(yōu)于對照組(P0.01)。血液流變學研究發(fā)現(xiàn),動物骨缺損造模后,全血血液黏度、血漿黏度與血小板聚集均顯著性升高(P0.01);術后8 w,研究組的全血黏度(1/200 s)、血漿粘度與血小板聚集率均顯著低于對照組(P0.05)。結論:0.5%摻鍶硫酸鈣對松質(zhì)骨骨缺損具有顯著的促進修復作用,而且能顯著改善由于骨缺損引起的全血黏度、血漿黏度與血小板聚集的異常升高,其效果優(yōu)于單純的硫酸鈣,是一種較好的骨修復材料。
[Abstract]:Objective: to observe the effect of local implantation of strontium-doped calcium sulfate on the repair of femoral condylar bone defect in rabbits and to explore the changes of hemorheology in the process of repair. Methods: 48 New Zealand rabbits with femoral condylar defects were randomly divided into strontium doped calcium sulfate group (study group), hemihydrate calcium sulfate group (control group) and model group. In the study group, the molar ratio of Sr Cl2 in bone defect was 0.5) the strontium calcium sulfate repair material was implanted in the bone defect area of the control group, and the defect site was left out in the model group. Ct imaging was performed at 412 weeks after operation to observe the repair of bone defect and to evaluate the new bone imaging score. The animals were killed at 812 weeks after operation. Alizarin red S and calmodulin were used for fluorescent labeling at 2 and 4 weeks after operation, and histomorphology was observed at 8 weeks after operation. Blood samples were collected from auricular vein before operation and 2 weeks after operation. Biochemical indexes and hemorheological indexes were measured. Results: the serum alkaline phosphatase (ALP) in the experimental animals was significantly higher than that before operation, and the ALP in the study group was significantly higher than that in the model group and the control group at 2 weeks after operation, and other biochemical indexes including glutamic oxaloacetic transaminase were significantly higher in the study group than in the model group and the control group. There was no significant difference in glutamate-pyruvic transaminase, urea nitrogen, creatinine and uric acid. Ct scan showed that at 12 weeks after operation, the local area of bone defect in the study group was filled with new bone tissue, and its density was almost the same as that of normal bone tissue. A small number of fragments of implant material can still be seen in the local bone defect. The imaging scores of new bone formation in the study group were higher than those in the control group at 4 weeks postoperatively (P 0.05). At 8 and 12 weeks after operation, the compressive strength of the femoral condylar defect in the study group was higher than that in the control group (P 0.05). The results of morphological study showed that the bone formation in the study group was significantly higher than that in the control group at 2 weeks, and the bone mineralization in the study group was significantly better than that in the control group at 4 weeks after operation. The results of hemorheology showed that the whole blood viscosity, plasma viscosity and platelet aggregation increased significantly after bone defect, and the whole blood viscosity, plasma viscosity and platelet aggregation rate of the study group were significantly lower than that of the control group (P 0.05) at 8 weeks after operation. Conclusion 0.5% calcium strontium sulfate can significantly promote the repair of cancellous bone defects, and can significantly improve the whole blood viscosity, plasma viscosity and platelet aggregation, which is superior to that of calcium sulfate alone. It is a good bone repair material.
【學位授予單位】：川北醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R580;R683

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