本文選題：骨延長術　切入點：胰島素樣生長因子-1　出處：《天津醫(yī)科大學》2015年碩士論文

【摘要】：目的:骨延長術是一種主要被用于糾正各種原因,包括先天發(fā)育不良、創(chuàng)傷、骨腫瘤等引起的骨短縮或骨缺失的手術技術。通過將骨斷端之間的距離緩慢延長達到形成新骨的目的。然而,延長周圍軟組織不能適應延長會造成軟組織,特別是肌肉相關的并發(fā)癥發(fā)生。胰島素樣生長因子-1作為一種體內(nèi)廣泛存在的促生長因子,被認為是肌肉組織中主要的調(diào)節(jié)肌肉損傷修復的細胞因子。本實驗主要評估脛骨延長術中脛前肌和腓腸肌在延長期間的變化,探究胰島素樣生長因子-1是否可以增加腓腸肌在延長期間的適應能力。方法:(1)使用80只8周齡的S-D大鼠,制作脛骨骨折延長模型。將80只模型鼠隨機分為對照組和延長組。在延長后第1、4、7和10天分別取延長組大鼠脛前肌和腓腸肌,對照組在相同時間取材。測量肌肉重量,肌纖維橫截面積,最大被動牽張力和剛度,以及相關基因Myo D、myogenin和myostatin的表達情況。(2)選取102只S-D大鼠,其中96只制作脛骨骨折延長模型。將制作的動物模型隨機分為生理鹽水注射組和胰島素樣生長因子-1注射組。未處理的大鼠為對照組。在延長之前,胰島素樣生長因子-1注射組的大鼠皮下注射胰島素樣生長因子-1,之后隔天注射。生理鹽水注射組在與胰島素樣生長因子-1注射的相同時間注射等量的生理鹽水。在延長第1、4、7和10天取兩組大鼠腓腸肌。對照組在其他兩組延長開始之間處死取材。測量肌肉重量,肌纖維橫截面積,膠原容積分數(shù),最大被動牽張力和最大主動收縮力和相關基因Akt、Myo D、myogenin和myostatin的表達情況。結果:(1)延長組脛前肌和腓腸肌都隨著延長而增加,但是在延長結束時仍低于正常。在延長組,脛前肌的最大被動牽張力增加明顯,然而,腓腸肌的略有降低。剛度在延長組的兩種肌肉中都表現(xiàn)出增加。Myo D和myogenin隨著延長出現(xiàn)顯著上調(diào),myostatin下調(diào)。(2)胰島素樣生長因子的注射促進肌肉重量增加。與對生理鹽水注射組的肌纖維橫截面積相比,胰島素樣生長因子-1注射組的顯著增加。在肌肉力學性能方面,胰島素樣生長因子-1不論是被動牽張力還是主動收縮力,相比于生理鹽水組都是增加的。Akt、Myo D和myogenin表現(xiàn)出上調(diào),而myostatin表達量下降。結論:(1)脛骨延長術可以改變延長部位脛前肌和腓腸肌形態(tài)學和力學性能改變。這種改變是不良的。脛前肌和腓腸肌對脛骨延長有一定的適應能力,并且脛前肌比腓腸肌的適應要好。(2)胰島素樣生長因子-1可以增加腓腸肌在脛骨延長術中的適應能力。注射外源性的胰島素樣生長因子-1可以減輕肌肉萎縮,阻止肌肉纖維化的發(fā)生,增加肌肉被動牽張力。胰島素樣生長因子-1在脛骨延長期間對肌肉的作用主要是調(diào)節(jié)肌肉代謝相關基因的表達實現(xiàn)的。
[Abstract]:Objective: bone lengthening is a major method used to correct various causes, including congenital dysplasia, trauma, Surgical techniques for bone shortening or bone loss caused by bone neoplasms. The formation of a new bone is achieved by slowly lengthening the distance between the broken ends of the bone. However, prolonging the surrounding soft tissue can result in soft tissue if it is not adapted to the lengthening. In particular, muscle-related complications occur. Insulin-like growth factor-1 (IGF-1) is widely present in the body as a growth promoting factor. This study was designed to evaluate the changes of the anterior tibial muscle and gastrocnemius muscle during the lengthening of the tibia. To investigate whether insulin-like growth factor-1 could increase the adaptability of gastrocnemius muscle during the prolonged period. Methods 80 8-week-old S-D rats were treated with 1: 1. 80 rats were randomly divided into control group and lengthening group. The tibial anterior muscle and gastrocnemius muscle were taken from the lengthened group on the 7th and 10th day after the lengthening, and the muscle weight was measured at the same time in the control group, and the tibial anterior muscle and gastrocnemius muscle were taken from the rats in the control group at the same time. The muscle fiber cross-sectional area, maximum passive stretch and stiffness, and the expression of Myo dymyogenin and myostatin were selected in 102 S-D rats. 96 of the animals were randomly divided into saline injection group and insulin-like growth factor-1 injection group. Untreated rats were used as control group. Rats in the insulin-like growth factor-1 injection group were subcutaneously injected with insulin-like growth factor-1 and then injected every other day. The saline injection group received the same amount of normal saline at the same time as the insulin-like growth factor-1 injection group. Gastrocnemius muscle was taken from rats on the 7th and 10th day after the first extension. The control group was killed between the other two groups and the muscle weight was measured. Muscle fiber cross-sectional area, collagen volume fraction, maximal passive tension, maximal active contractility and the expression of Aktnolia danmyogenin and myostatin. Results the tibial anterior muscle and gastrocnemius muscle increased with the prolongation. However, at the end of the extension, the maximal passive tension of the anterior tibial muscle increased significantly. The stiffness of gastrocnemius muscle increased slightly in both groups. Myo D and myogenin increased significantly with prolongation) the injection of insulin-like growth factor promoted the increase of muscle weight. Compared with the cross-sectional area of muscle fibers in the water injection group, In terms of muscle mechanical properties, insulin-like growth factor-1 (IGF-1) was up-regulated both in passive tension and active contractility, compared with that in saline group. Conclusion tibial lengthening can change the morphological and mechanical properties of tibial anterior muscle and gastrocnemius muscle, which is not good. Tibial anterior muscle and gastrocnemius muscle have some adaptability to tibial lengthening. Furthermore, the anterior tibial muscle was more adaptable than gastrocnemius muscle.) insulin-like growth factor-1 increased the adaptability of gastrocnemius muscle in tibial lengthening. Injection of exogenous insulin-like growth factor -1 reduced muscle atrophy. The effect of insulin-like growth factor-1 on muscle during tibial lengthening is mainly due to the regulation of the expression of metabolism-related genes in muscle.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R687.3

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