本文選題：骨質(zhì)疏松癥 + 全髖置換��； 參考：《長江大學(xué)》2015年碩士論文

【摘要】：我國現(xiàn)已經(jīng)進(jìn)入老齡化階段,平均壽命的增長使得越來越多患有股骨頭壞死或意外性股骨頸骨折的老年人選擇人工髖關(guān)節(jié)假體置換手術(shù)以提高生活質(zhì)量。自本世紀(jì)30年代開始由Charnley首次應(yīng)用全髖關(guān)節(jié)置換術(shù)應(yīng)用于臨床以后,逐漸成為重建關(guān)節(jié)功能的主要手段。隨之手術(shù)量的逐漸增加及應(yīng)用范圍的擴(kuò)大,術(shù)后并發(fā)癥也逐漸顯露出來,其中以置換后假體的無菌性松動最常見,成為困擾醫(yī)生和患者的難題,進(jìn)而最終導(dǎo)致假體在使用期限內(nèi)的二次或多次翻修。因此,對人工關(guān)節(jié)無菌性松動原因和機(jī)制的研究,依此探討可行的預(yù)防和治療方案,使假體壽命延長成為迫在眉睫的技術(shù)方向。近幾年很多學(xué)者的研究已證實(shí),人工關(guān)節(jié)假體無菌性松動誘導(dǎo)原因包括磨屑顆粒、微動、應(yīng)力遮擋以及外界因素的介入如工作環(huán)境、自身體重、關(guān)節(jié)腔高液體壓力等,其中最重要的因素就是磨屑顆粒所誘導(dǎo)。大多數(shù)學(xué)者研究認(rèn)為,巨噬細(xì)胞、成纖維細(xì)胞、異物巨細(xì)胞、成骨細(xì)胞等在磨屑顆粒的刺激下產(chǎn)生能誘導(dǎo)破骨細(xì)胞生產(chǎn)的骨吸收因子,如：腫瘤壞死因子-α(TOF-α)、白細(xì)胞介素-1(IL-1)和白細(xì)胞介素-6(IL-6)等可直接增強(qiáng)破骨細(xì)胞的骨吸收能力,使人工關(guān)節(jié)置換周圍的骨發(fā)生溶解或吸收,假體與骨之間微動產(chǎn)生松動。綜上可知,破骨細(xì)胞的數(shù)量增多及功能異常,直接影響到假體與骨之間的穩(wěn)定性,致使周圍骨組織骨溶解吸收,最終導(dǎo)致人工關(guān)節(jié)置換手術(shù)的失敗。若以此推理,我們不難得知,通過抑制破骨細(xì)胞的活性,減少破骨細(xì)胞的數(shù)量來積極延緩或抑制骨溶解或骨吸收,是否能延長置換后假體使用壽命呢?鮭魚降鈣素作用的源頭就在于破骨細(xì)胞。通過對其臨床中治療骨質(zhì)疏松患者的過程中可證實(shí),藥理劑量的鮭魚降鈣素能夠完全抑制破骨細(xì)胞的骨吸收,并且破骨細(xì)胞數(shù)量也明顯下降,從而降低骨量丟失。本課題擬以此為出發(fā)點(diǎn),通過對降鈣素及其特異性受體的研究,進(jìn)行如下相關(guān)研究,為臨床提高人工關(guān)節(jié)置換術(shù)后假體使用壽命提供實(shí)驗(yàn)依據(jù)。本次課題研究中主要包括以下三個內(nèi)容：1.骨質(zhì)疏松癥患者全髖置換中應(yīng)用鮭魚降鈣素治療后影響假體翻修的分析2.磨屑顆粒誘導(dǎo)假體松動的動物實(shí)驗(yàn)研究3.鮭魚降鈣素與人工關(guān)節(jié)無菌性松動的相關(guān)性研究第一部分：骨質(zhì)疏松癥患者全髖置換中應(yīng)用鮭魚降鈣素治療后影響假體翻修的分析目的：回顧性分析5年內(nèi)骨質(zhì)疏松患者接受初次全髖置換術(shù)后應(yīng)用鮭魚降鈣素對于假體二次翻修的影響,探討初次全髖置換術(shù)后應(yīng)用鮭魚降鈣素與假體的臨床使用壽命之間的可能存在的相關(guān)性。方法：隨機(jī)選取作者所在實(shí)習(xí)醫(yī)院(荊州市中心醫(yī)院)病例科2010年-2015年間行人工髖關(guān)節(jié)置換術(shù)患者病例500例552髖(病種不限),其中存在骨質(zhì)疏松癥病例126例(檢索過程中存在雙髖關(guān)節(jié)置換患者從總病例數(shù)中已扣除)；將目標(biāo)樣本以二次翻修為條件進(jìn)行篩選后,可檢索出43例因不同原因接受二次翻修,其中將17例患者在初次換髖術(shù)后應(yīng)用鮭魚降鈣素的骨質(zhì)疏松患者擬為A組；在剩余26例中隨機(jī)抽取17例為B組進(jìn)行臨床對照。將A、B兩組數(shù)據(jù)分別查閱患者假體類型、年齡、性別、初次換髖時間至翻修時間(手術(shù)部位不分左右),采用SPSS17.0統(tǒng)計學(xué)軟件對數(shù)據(jù)進(jìn)行分析,骨質(zhì)疏松癥患者中鮭魚降鈣素治療組與非治療組患者假體翻修率,以P0.05表示差異具有統(tǒng)計學(xué)意義。結(jié)果：A組中患者年齡階段為72-84歲,平均年齡76.8歲；男性6例,女性11例；B組年齡56-82歲,平均年齡68.6歲；男性8例,女性9例,比較差異不具有統(tǒng)計學(xué)意義(P0.05)。A組初次換髖時間至翻修時間最短時間26個月,最長時間49個月,平均35.7個月；B組最短時間為14個月,最長時間33個月,平均23.5個月,比較差異具有統(tǒng)計學(xué)意義(P0.05)結(jié)論：目前鮭魚降鈣素已經(jīng)是治療骨質(zhì)疏松癥的常見藥物之一,在治療OP的過程中也抑制破骨細(xì)胞的形成,進(jìn)而可降低假體周圍骨溶解,使假體與骨之間不能輕易產(chǎn)生微動或下沉,進(jìn)而提高假體使用壽命。樣本以二次翻修為條件進(jìn)行篩選后,可檢索出43例因不同原因接受二次翻修,其中將17例患者在初次換髖術(shù)后應(yīng)用鮭魚降鈣素的骨質(zhì)疏松患者擬為A組；在剩余26例中隨機(jī)抽取17例為B組進(jìn)行臨床對照。將A、B兩組數(shù)據(jù)分別查閱患者假體類型、年齡、性別、初次換髖時間至翻修時間(手術(shù)部位不分左右),采用SPSS17.0統(tǒng)計學(xué)軟件對數(shù)據(jù)進(jìn)行分析,骨質(zhì)疏松癥患者中鮭魚降鈣素治療組與非治療組患者假體翻修率,以P0.05表示差異具有統(tǒng)計學(xué)意義。結(jié)果：A組中患者年齡階段為72-84歲,平均年齡76.8歲；男性6例,女性11例；B組年齡56-82歲,平均年齡68.6歲；男性8例,女性9例,比較差異不具有統(tǒng)計學(xué)意義(P0.05)。A組初次換髖時間至翻修時間最短時間26個月,最長時間49個月,平均35.7個月；B組最短時間為14個月,最長時間33個月,平均23.5個月,比較差異具有統(tǒng)計學(xué)意義(P0.05)結(jié)論：目前鮭魚降鈣素已經(jīng)是治療骨質(zhì)疏松癥的常見藥物之一,在治療OP的過程中也抑制破骨細(xì)胞的形成,進(jìn)而可降低假體周圍骨溶解,使假體與骨之間不能輕易產(chǎn)生微動或下沉,進(jìn)而提高假體使用壽命。第二部分：磨屑顆粒誘導(dǎo)假體松動的動物實(shí)驗(yàn)研究目的：通過對磨屑顆粒誘導(dǎo)假體無菌性松動的機(jī)制的理解下制作動物模型,并取假體周圍骨及界膜組織進(jìn)行研究分析,探討磨屑顆粒對假體-骨間骨量變化、破骨細(xì)胞變化及其組織形態(tài)的影響。方法：采用無菌健康成年新西蘭大白兔12只(由湖北中醫(yī)藥高等�？茖W(xué)校實(shí)驗(yàn)動物中心提供并飼養(yǎng)),體重23±0.4 Kg,雌雄不限。隨機(jī)平均分為實(shí)驗(yàn)組和對照組且均選取左側(cè)髖關(guān)節(jié)為實(shí)驗(yàn)部位。實(shí)驗(yàn)組在術(shù)后4周每次向關(guān)節(jié)腔無菌注射磨屑顆粒混合液0.5ml,對照組無菌注射生理鹽水0.5ml,直至術(shù)后16周后檢測假體周圍感應(yīng)區(qū)骨密度(BMD)變化。術(shù)后滿16周后處死兩組實(shí)驗(yàn)動物,取假體周圍組織行大體及光學(xué)顯微鏡下觀察、細(xì)菌培養(yǎng)、并做放免法測定TNF-α、IL-6含量。結(jié)果：假體四周感應(yīng)區(qū)BMD的改變中實(shí)驗(yàn)組明顯下降,兩組間有顯著性差異升高(P0.05),且實(shí)驗(yàn)組組間對比可見隨著時間的推移,直至16周后比較術(shù)前BMD有顯著性差異(P0.01)。對照組BMD未見明顯改變,同組內(nèi)對比結(jié)果無統(tǒng)計學(xué)差異(P0.05)。大體觀察鈦合金假體周圍情況,實(shí)驗(yàn)組的假體周圍包裹了一層纖維樣組織膜；而對照組沒有這樣類似的纖維膜,而緊貼骨組織或有一層新生骨組織包裹。細(xì)菌培養(yǎng)結(jié)果可見兩組均表現(xiàn)為陰性。放免檢測可見實(shí)驗(yàn)組組織中的TNF-α、IL-6含量均明顯高于對照組,具有統(tǒng)計學(xué)差異(P0.05)有意義。結(jié)論：本次動物模型的制作基本相似于臨床上人工關(guān)節(jié)置換后假體無菌性松動的襯性骨溶解。由此推理,磨屑顆粒就是導(dǎo)致人工髖關(guān)節(jié)置換后假體周圍骨量丟失及增加破骨細(xì)胞數(shù)目的主要因素。最終以假體周圍骨質(zhì)破壞、假體松動為臨床表現(xiàn),迫使其使用壽命縮短。第三部分：鮭魚降鈣素與人工關(guān)節(jié)無菌性松動的相關(guān)性研究目的：實(shí)驗(yàn)性研究治療骨質(zhì)疏松藥物鮭魚降鈣素對于全髖關(guān)節(jié)置換術(shù)后假體松動的預(yù)防作用,并探討其在臨床中應(yīng)用的可能性分析。方法：選取健康成年且在無菌條件下飼養(yǎng)的新西蘭大白兔18只(由湖北中醫(yī)藥高等�？茖W(xué)校實(shí)驗(yàn)動物中心提供并飼養(yǎng))；體重2.3±0.4 Kg,雌雄不限。分別為藥物實(shí)驗(yàn)組、動模對照組及空白生理鹽水對照組,并均選取左側(cè)髖關(guān)節(jié)為實(shí)驗(yàn)部位。術(shù)后第四周開始,分別于術(shù)后第4、6、8、10、12、14周向藥物實(shí)驗(yàn)組及動模對照組的兔左髖關(guān)節(jié)腔在無菌的條件下注射磨屑顆粒混合懸液(鈦合金及聚乙烯顆粒),空白生理鹽水對照組注射生理鹽水均為每次1ml,每2周一次,直至術(shù)后14周。術(shù)后第二周開始向藥物實(shí)驗(yàn)組大白兔的手術(shù)側(cè)關(guān)節(jié)囊內(nèi)注射降鈣素1ml,每3天一次,直到第16周。同時其余兩組大白兔的手術(shù)側(cè)關(guān)節(jié)囊內(nèi)注射生理鹽水lml,同樣每3天一次,直至第16周。三組大白兔在試驗(yàn)周內(nèi)每日喂養(yǎng)含有鈣爾奇藥物成分的食物。采取大體觀察、假體周圍細(xì)菌培養(yǎng)、光學(xué)顯微鏡下觀察假體周圍組織形態(tài)改變,并檢測假體周圍感應(yīng)區(qū)骨密度(BMD)、放免法測定TNF-α、IL-6含量。結(jié)果：大體觀察：將動物處死后手術(shù)取出模擬人工假體后,可見藥物實(shí)驗(yàn)組及生理鹽水對照組人工假體周圍骨小梁較為完整,動模對照組人工假體周圍包裹了一層纖維樣組織,骨小梁較藥物組明顯破壞。藥物實(shí)驗(yàn)組與空白生理鹽水對照組組間對比無明顯差異。細(xì)菌培養(yǎng)結(jié)果可見三組.均表現(xiàn)為陰性。藥物實(shí)驗(yàn)組界膜組織表現(xiàn)為成熟的骨組織、少量的纖維結(jié)締組織或有新生骨形成,未見明顯的組織細(xì)胞反應(yīng)。動模對照組人工假體周圍產(chǎn)生一層含有大量的巨噬細(xì)胞和異物巨細(xì)胞的纖維結(jié)締組織界膜。生理鹽水對照組由于手術(shù)過程中破壞周圍組織可見輕度創(chuàng)傷性炎癥改變。藥物治療組在介入鮭魚降鈣素治療后,假體周圍骨量較單純動物模型組丟失明顯減少,兩者之間存在差異(P0.05),具有統(tǒng)計學(xué)意義；兩組對照組經(jīng)過對比,可見磨屑顆粒動物模型組骨量丟失明顯比生理鹽水空白對照組高,兩者之間存在明顯差異(P0.01),具有統(tǒng)計學(xué)意義；藥物治療組與空白生理鹽水對照組之間,在短期內(nèi)(8周以內(nèi))骨量丟失量無明顯差異(P0.05)；但在8周以后可見鮭魚降鈣素治療組骨量丟失相對較多,兩者存在差異(P0.05)。具有統(tǒng)計學(xué)意義。結(jié)果經(jīng)統(tǒng)計顯示藥物治療組的組織中TNF-α及IL-6含量明顯低于動物模型對照組,具有統(tǒng)計學(xué)差異(P0.05)有意義。兩組對照組之間可見動物模型組中TNF-α及IL-6含量明顯升高,兩者存在顯著差異(P0.01),具有統(tǒng)計學(xué)意義。而藥物治療組與生理鹽水對照組中的TNF-α及IL-6含量差異性不明顯,(P0.05),不具有統(tǒng)計學(xué)意義。結(jié)論：鮭魚降鈣素能夠通過影響破骨細(xì)胞活性,促使破骨細(xì)胞的數(shù)量驟減,從而使磨屑顆粒誘導(dǎo)下的骨溶解機(jī)制減慢,間接性的提高人工關(guān)節(jié)置換假體與骨之間的壽命。
[Abstract]:Our country is now entering the aging stage. The growth of average life expectancy makes more and more elderly people with femoral head necrosis or accidental femoral neck fracture to choose artificial hip prosthesis replacement to improve the quality of life. Since 30s this century, the first application of total hip arthroplasty by Charnley was gradually applied to the clinic. As the main means of reconstruction of joint function. With the gradual increase of the amount of operation and the expansion of the scope of application, postoperative complications are gradually revealed. Among them, the most common aseptic loosening of prostheses after replacement has become a difficult problem for doctors and patients, which eventually leads to the two or multiple refurbishment of the prosthesis in the duration of use. Research on the causes and mechanisms of aseptic loosening of the joints is studied, and the feasible prevention and treatment scheme is discussed, and the life span of the prosthesis has become an urgent technical direction. In recent years, many scholars have confirmed that the causes of aseptic loosening of artificial joint prosthesis include debris particles, micromovement, stress shielding, and external factors intervention. The most important factor, such as working environment, body weight, high fluid pressure in the joint cavity, is the induction of debris particles. Most scholars have considered that macrophages, fibroblasts, foreign body giant cells, osteoblasts, and so on produce bone resorption factors that can induce osteoclast production under the stimulation of debris particles, such as the cause of the tumor's bad death Sub - alpha (TOF- - alpha), interleukin -1 (IL-1) and interleukin -6 (IL-6) can directly enhance the bone resorption of osteoclasts, dissolve or absorb the bone around the replacement of the prosthesis, and the movement between the prosthesis and the bone leads to the loosening of the bone. It is known that the number of osteoclasts and the abnormal function are directly affected by the prosthesis and bone. Stability, resulting in the absorption of osteolysis around the bone tissue and the failure of artificial joint replacement surgery. In this case, it is not difficult to know whether to postpone or inhibit osteolysis or bone resorption by inhibiting the activity of osteoclasts, reducing the number of osteoclasts, and prolonging the life of the prosthesis after replacement? Salmon calcitonin The source of the use is osteoclast. Through the treatment of patients with osteoporosis in clinical treatment, it is proved that the pharmacological dose of salmon calcitonin can completely inhibit bone resorption of osteoclast and decrease the number of osteoclasts, thus reducing the loss of bone mass. The study of heterosexual receptors is conducted to provide an experimental basis for clinical improvement of the life span of prosthesis prosthesis. In this study, the following three contents are included: 1. analysis of the effect of salmon calcitonin in the total hip replacement of osteoporosis patients and the analysis of prosthesis refurbishment after the use of salmon calcitonin, 2. debris induced prosthesis A study of the relationship between 3. salmon calcitonin and aseptic loosening of artificial joints. Part 1: analysis of the effects of salmon calcitonin in total hip replacement for osteoporosis patients affecting prosthesis revision: retrospective analysis of the use of salmon calcitonin for 5 years after primary total hip replacement for patients with osteoporosis The possible correlation between the clinical service life of salmon calcitonin and prosthesis after primary total hip replacement was investigated in the effect of two refurbishment of prostheses. Methods: randomly selected 500 cases of 552 hip arthroplasty cases in the case Department of the author's Hospital (Jingzhou Central Hospital) in -2015 in 2010 (500 cases of hip arthroplasty). There are 126 cases of osteoporosis in which there are 126 cases of osteoporosis (double hip replacement patients have been deducted from the total number of cases). After screening the target samples with two refurbishment conditions, 43 cases can be retrieved for two refurbishment for different reasons, of which 17 patients are used for salmon calcitonin after the first hip replacement. The patients with osteoporosis were intended to be A group; 17 of the remaining 26 cases were randomly selected as group B for clinical control. The data of A and B two groups were examined for the type of prosthesis, age, sex, the first hip change time to the refurbishment time (the surgical site was not about), the data were analyzed with the SPSS17.0 statistics software, and the salmon in the osteoporosis patients. The prosthesis revision rate in the calcitonin treatment group and the non treatment group was statistically significant by P0.05. Results: the age of the patients in the A group was 72-84 years old, the average age was 76.8 years, 6 men and 11 women, the B group was 56-82 years old, the average age was 68.6 years, the male 8 cases and the female 9 cases were not statistically significant (P0.05).A. The shortest time for the first time to change the hip to the refurbishment time is 26 months, the longest time is 49 months, an average of 35.7 months. The shortest time of group B is 14 months, the longest time is 33 months, the average is 23.5 months, the difference is statistically significant (P0.05) conclusion: salmon calcitonin is one of the common drugs for the treatment of osteoporosis, and is in the treatment of OP In the process, the formation of osteoclast is inhibited, and the osteolysis around the prosthesis can be reduced, and the prosthesis and bone can not be freed or sink easily, and then the life span of the prosthesis is improved. After screening the samples with two refurbishment conditions, 43 cases can be retrieved for two refurbishment for different reasons, of which 17 patients are changed to the hip for the first time. The osteoporosis patients with salmon calcitonin were planned to be A group, and 17 of the remaining 26 cases were randomly selected as B group for clinical control. The data of A and B two groups were examined for the type of prosthesis, age, sex, the first time of hip replacement and the time of revision (the surgical site was not divided), and the data were analyzed by SPSS17.0 statistics software. The rate of prosthesis revision in the salmon calcitonin treatment group and the non treatment group was statistically significant by P0.05. Results: the age of the patients in the A group was 72-84 years, the average age was 76.8 years, 6 men and 11 women, the B group was 56-82 years old, the average age was 68.6 years, 8 men and 9 women. Statistical significance (P0.05) group.A first time for the first time to change the hip time to the shortest time 26 months, the longest time of 49 months, an average of 35.7 months, the shortest time in group B is 14 months, the longest time 33 months, the average 23.5 months, the difference is statistically significant (P0.05) conclusion: salmon calcitonin is now a common drug for the treatment of osteoporosis One of them also inhibits the formation of osteoclasts during the treatment of OP, and then reduces osteolysis around the prosthesis, so that the prosthesis and bone can not easily produce fretting or sinking, and thus the life of the prosthesis is improved. The second part: Animal Experimental Study of debris particles induced prosthesis loosening by abrasive particles: no prosthesis induced by debris particles Under the understanding of the mechanism of bacterial loosening, the animal model was made, and the periprosthetic bone and boundary membrane tissues were studied. The effects of debris particles on the changes of bone mass, osteoclast and tissue morphology were investigated. Methods: 12 New Zealand white rabbits were used in aseptic healthy adult New Zealand (Hubei College of Chinese Medicine experiment). The animal center was provided and raised with a weight of 23 + 0.4 Kg and male and female. The experimental group was randomly divided into the experimental group and the control group. The left hip joint was selected as the experimental site. The experimental group was injected with the mixture of debris particles 0.5ml to the articular cavity 4 weeks after the operation, and the control group was aseptic injected with the physiological saline 0.5ml until 16 weeks after the operation to detect the periprosthesis. The bone mineral density (BMD) changes in the induction area. After 16 weeks after operation, two groups of experimental animals were killed. The tissues around the prosthesis were observed under the microscope, the bacteria culture and the radioimmunoassay were used to determine the TNF- alpha and IL-6 content. Results: the experimental group decreased significantly in the BMD changes around the prosthesis, and there was a significant difference between the two groups (P0.05), and the experiment The comparison between group groups showed that there were significant differences in BMD before 16 weeks (P0.01). There was no significant change in BMD in the control group, and there was no significant difference between the same group (P0.05). The periprosthesis of the experimental group was wrapped around a fibrous tissue membrane around the prosthesis in the experimental group; and the control group did not have this Similar fibrous membrane, and clingy bone tissue or a layer of new bone tissue wrapped. Bacterial culture results showed that the two groups were negative. The radioimmunoassay showed that the content of TNF- alpha in the experimental group was significantly higher than that of the control group. The statistical difference (P0.05) was significant. Conclusion: the animal model was basically similar to the clinical model. Aseptic osteolysis of aseptic loosening of prosthesis after replacement of prosthesis. It is concluded that debris is the main factor leading to the loss of bone mass around the prosthesis and the increase of the number of osteoclasts after the replacement of the hip prosthesis. The final bone destruction around the prosthesis, the prosthesis loosening is the clinical manifestation, and the life span is shortened. Third parts: A study on the correlation between salmon calcitonin and aseptic loosening of artificial joints: an experimental study on the preventive effect of salmon calcitonin on prosthesis loosening after total hip replacement and the possibility analysis of its clinical application. 18 rabbits (provided and fed by experimental animal center of Hubei College of Chinese Medicine); weight 2.3 + 0.4 Kg, male and female, and male and female. They were the experimental group, the dynamic model control group and the blank saline control group, and the left hip joint was selected as the experimental site. Fourth weeks after the operation, the drug was given to the drug after the operation, respectively. The left hip joint cavity of the rabbits in the experimental group and the dynamic model control group was injected with abrasive particles mixed suspension (titanium alloy and polyethylene) under aseptic conditions. The blank saline control group was injected with 1ml each time, once every 2 weeks, until 14 weeks after the operation. The operation side of the experimental group began to be injected into the operation side of the experimental group of rabbits at second weeks. Calcitonin 1ml, once every 3 days, until sixteenth weeks. At the same time, the other two groups of rabbits were injected with saline LML in the surgical side of the joint capsule, once every 3 days, and until sixteenth weeks. The three groups of rabbits fed the calchic ingredients daily within the test week. The changes of tissue morphology around the prosthesis were observed and the bone mineral density (BMD) around the induction area around the prosthesis was detected, and the radioimmunoassay was used to determine the TNF- alpha and IL-6 content. Results: general observation: after the animal was executed, the simulated prosthesis was removed, and the bone trabecula around the artificial body of the drug experiment group and the saline control group was more complete, and the dynamic model control group was artificial false. A layer of fibrous tissue was wrapped around the body, and the bone trabecula was significantly damaged than the drug group. There was no significant difference between the drug experiment group and the blank saline control group. The results of the bacterial culture showed that the three groups were negative. The membrane tissue of the drug experiment group showed mature bone tissue, a small amount of fibrous connective tissue or new bone shape. A layer of fibrous connective tissue boundary membrane containing a large number of macrophages and foreign body giant cells was produced around the prosthesis in the control group. In the saline control group, mild traumatic inflammation was seen in the surrounding tissue during the operation. The drug treatment group was treated with salmon calcitonin treatment in the drug treatment group. The bone mass around the prosthesis was significantly less than that of the simple animal model group, and there was a significant difference between the two groups (P0.05). The comparison between the two groups showed that the bone mass loss of the animal model group was significantly higher than that of the normal saline blank control group, and there was a significant difference between the two groups (P0.01), with statistical significance. There was no significant difference in bone mass loss between the treatment group and the blank control group (P0.05) in the short term (P0.05), but the bone loss in the salmon calcitonin group was relatively large after 8 weeks, and there was a difference between the two groups (P0.05). The statistical significance was statistically significant. The results showed that the content of TNF- alpha and IL-6 in the tissue of the drug treatment group was clear. Significantly lower than the animal model control group, with statistical difference (P0.05) significant. Between the two groups of control, TNF- and IL-6 contained in the animal model group.
【學(xué)位授予單位】：長江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.4

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1 王長海;付金樂;史，

本文編號：1937692