激素治疗对去势大鼠骨折愈合及对子宫内膜影响的对比研究

目的探讨利维爱、倍美力和补佳乐在骨质疏松性骨折愈合中的作用及对子宫内膜的影响。方法将6月龄雌性SD大鼠分为假手术（SHAM）组、去势（OVX）组、利维爱组、倍美力组和补佳乐组。除SHAM组外其余各组均切除双侧卵巢建立绝经后骨质疏松动物模型。去势后8周各组行右股骨骨折建立骨折模型，同时利维爱组、倍美力组、补佳乐组开始服药。五组均在骨折后第2、4、6、8周处死大鼠后行HE染色观察骨痴骨小粱面积，成、破骨细胞的形态计量，以及宫内膜HE染色及形态计量。结果①骨痂形态计量：骨折后骨小粱面积利维爱组〉倍美力组〉补佳乐组。且在4周时最明显。三个用药组骨小梁表面成骨细胞增多，破骨细胞减少。在第2、4周时各用药组的破骨细胞数明显少于OVX组。与SHAM组的差异无统计学意义。成骨细胞数除用药组中补佳乐组6周时低于其他各组外，用药组与SHAM组、OVX组在各时段的差异无统计学意义。②子宫内膜形态计量t骨折后第2～6周各组间的差异无统计学意义。第8周时OVX组内膜薄，上皮细胞低柱状，腺体数明显减少;用药组中利维爱组内膜上皮细胞和腺体增生不明显，明显低于SHAM组，补佳乐组和倍美力组与SHAM组相似。结论本实验结果显示雌激索对于促进绝经后骨质疏松性骨折的愈合是有效的。不同的雌激素由于成分不同效果有差异。8周时形态计量上尚未发现补佳乐、倍美力和利维爱对宫内膜的增生作用。

Comparative Study of Effects of Hormonal Therapies on the Healing of Fracture in Ovariectomized Rats and Rats' Endometria

OBJECTIVE: To compare the effects of Livial, Progynova and Premarin on osteoporosis associated with femoral fracture in rats, and assess these drugs' influnces on the rats' endometria in order to provide a therapeutic regiment appropriate for postmenopausal osteoporotic fracture. METHODS: Ninety 6-month-old SD female rats were randomly divided into five groups:SHAM, OVX, Livial, Progynova and Premarin. The osteoporotic model was established by ovariectomy except for Sham group. The right femur was broken by operation 8 weeks later. Livial, Progynova,Premarin tablets were given after operation respectively. The rats in five groups were killed at the end of 2, 4, 6, 8 weeks after operation respectively. The study indices included the histological appearance and histomorphometry of bone calluses, osteoblasts, osteoclasts, and endometrium. RESULTS: There were more osteoclasts in OVX group than in other four groups,but no statistically significant differences in number of osteoblasts on the surface of osseous trabecula were seen among the five groups. The biggest area of trabecula was in Livial group while the smallest area was in Progynova group, especially at 4 weeks after operation. The hyperplasia of endometrium measured by morphometry was the same in the Progynova,Premarin groups as in Sham group, whereas it was not found in Livial group at 8 weeks postfracture. CONCLUSION: Estrogen is good for healing of postmenopausal osteoporotic fracture. The possible mechanism relevant to healing is that estrogen inhibits bone absorption, stimulates bone formation, reduces bone turnover and accelerates bone-remodeling. When compared against the treatment with estrogen alone, the treatment with combined sex hormones has better effects on fracture healing. Livial would not bring about endometrium hyperplasia.