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

【摘要】：目的:骨延長(zhǎng)術(shù)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(shù)技術(shù)。通過(guò)將骨斷端之間的距離緩慢延長(zhǎng)達(dá)到形成新骨的目的。然而,延長(zhǎng)周圍軟組織不能適應(yīng)延長(zhǎng)會(huì)造成軟組織,特別是肌肉相關(guān)的并發(fā)癥發(fā)生。胰島素樣生長(zhǎng)因子-1作為一種體內(nèi)廣泛存在的促生長(zhǎng)因子,被認(rèn)為是肌肉組織中主要的調(diào)節(jié)肌肉損傷修復(fù)的細(xì)胞因子。本實(shí)驗(yàn)主要評(píng)估脛骨延長(zhǎng)術(shù)中脛前肌和腓腸肌在延長(zhǎng)期間的變化,探究胰島素樣生長(zhǎng)因子-1是否可以增加腓腸肌在延長(zhǎng)期間的適應(yīng)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(zhǎng)模型。將80只模型鼠隨機(jī)分為對(duì)照組和延長(zhǎng)組。在延長(zhǎng)后第1、4、7和10天分別取延長(zhǎng)組大鼠脛前肌和腓腸肌,對(duì)照組在相同時(shí)間取材。測(cè)量肌肉重量,肌纖維橫截面積,最大被動(dòng)牽張力和剛度,以及相關(guān)基因Myo D、myogenin和myostatin的表達(dá)情況。(2)選取102只S-D大鼠,其中96只制作脛骨骨折延長(zhǎng)模型。將制作的動(dòng)物模型隨機(jī)分為生理鹽水注射組和胰島素樣生長(zhǎng)因子-1注射組。未處理的大鼠為對(duì)照組。在延長(zhǎng)之前,胰島素樣生長(zhǎng)因子-1注射組的大鼠皮下注射胰島素樣生長(zhǎng)因子-1,之后隔天注射。生理鹽水注射組在與胰島素樣生長(zhǎng)因子-1注射的相同時(shí)間注射等量的生理鹽水。在延長(zhǎng)第1、4、7和10天取兩組大鼠腓腸肌。對(duì)照組在其他兩組延長(zhǎng)開(kāi)始之間處死取材。測(cè)量肌肉重量,肌纖維橫截面積,膠原容積分?jǐn)?shù),最大被動(dòng)牽張力和最大主動(dòng)收縮力和相關(guān)基因Akt、Myo D、myogenin和myostatin的表達(dá)情況。結(jié)果:(1)延長(zhǎng)組脛前肌和腓腸肌都隨著延長(zhǎng)而增加,但是在延長(zhǎng)結(jié)束時(shí)仍低于正常。在延長(zhǎng)組,脛前肌的最大被動(dòng)牽張力增加明顯,然而,腓腸肌的略有降低。剛度在延長(zhǎng)組的兩種肌肉中都表現(xiàn)出增加。Myo D和myogenin隨著延長(zhǎng)出現(xiàn)顯著上調(diào),myostatin下調(diào)。(2)胰島素樣生長(zhǎng)因子的注射促進(jìn)肌肉重量增加。與對(duì)生理鹽水注射組的肌纖維橫截面積相比,胰島素樣生長(zhǎng)因子-1注射組的顯著增加。在肌肉力學(xué)性能方面,胰島素樣生長(zhǎng)因子-1不論是被動(dòng)牽張力還是主動(dòng)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(dá)量下降。結(jié)論:(1)脛骨延長(zhǎng)術(shù)可以改變延長(zhǎng)部位脛前肌和腓腸肌形態(tài)學(xué)和力學(xué)性能改變。這種改變是不良的。脛前肌和腓腸肌對(duì)脛骨延長(zhǎng)有一定的適應(yīng)能力,并且脛前肌比腓腸肌的適應(yīng)要好。(2)胰島素樣生長(zhǎng)因子-1可以增加腓腸肌在脛骨延長(zhǎng)術(shù)中的適應(yīng)能力。注射外源性的胰島素樣生長(zhǎng)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(dòng)牽張力。胰島素樣生長(zhǎng)因子-1在脛骨延長(zhǎng)期間對(duì)肌肉的作用主要是調(diào)節(jié)肌肉代謝相關(guān)基因的表達(dá)實(shí)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(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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