骨健颗粒促进家兔骨折愈合的实验研究

目的:通过骨健颗粒促进家兔骨痂中转化生长因子-β1(TGF-β1)、骨形态蛋白-2(BMP-2)及血清骨钙素(BGP)表达和血液流变学指标研究,探讨其促进骨折愈合的机制.方法:125只桡骨骨折模型兔随机分为模型组(A组)、伤科接骨片组(B组,又称阳性对照组)及骨健颗粒低剂量组(C组)、中剂量组(D组)、高剂量组(E组),每组25只,分别于术后第2天开始给药,1次/日,A组给予生理盐水10 mL·kg-1,B组给予伤科接骨片200 mg· kg-1、C组给予骨健颗粒0.4g· kg-1、D组给予骨健颗粒0.81 g·kg-1、E组给予骨健颗粒1.62g· kg-1,均以10 mL·kg-1生理盐水混匀ig.分别于术后第1,2,3,4,6周取材,采用免疫组化染色,应用图像分析的方法测定家兔骨痂中TGF-β1和.BMP-2含量;用放免仪检测外周静脉血BGP的含量;用血黏度测试仪检测术后2周时的血液流变学指标.结果:B ～E组骨痂中TGF-β1和BMP-2在术后2周时出现高峰,A组在3周出现高峰,峰值比较D组＞E组＞C组＞B组＞A组;各组BGP均在3周时出现高峰,峰值比较D组＞E组＞C组＞B组＞A组;2周时血液流变学指标全血高切、全血低切D组和A组、B组、C组、E组比较P＜0.01或P＜0.05;血沉、压积、血浆黏度D组和A组、B组、C组比较P＜0.01.结论:骨健颗粒较其他组能促进家兔骨痂中TGF-β1、BMP-2的表达且峰值较A组提前出现,能提高血清BGP的峰值,明显降低全血黏度、红细胞压积和血浆黏度,以中剂量效果为著.结论:骨健颗粒明显缩短家兔骨折愈合的时间和提高骨折愈合的质量.     

补肝肾健脾温针灸法防治原发性骨质疏松症及骨量减少的临床研究

目的:探讨补肝肾健脾温针灸法防治原发性骨质疏松症及骨量减少的作用。方法:分别将原发性骨质疏松症63例随机分为针灸治疗组32例和药物治疗组31例,骨量减少患者40例随机分为针灸防治组20例和药物防治组20例,针灸治疗组和防治组均选取大杼、肝俞、肾俞、足三里、阳陵泉、三阴交、悬钟、关元,予针灸治疗,隔日1次,治疗45天次;药物组口服维丁钙片,4片/次,3次/d,连续3个月。观察各组治疗前后的骨密度(BMD)、骨钙素(BGP)、骨痛积分、衰老积分及临床疗效。结果:治疗结束后3个月,针灸治疗组的L2-L4、左股骨Neck、Ward区及GT骨密度较治疗前均有明显增加(P<0.01,或P<0.05);药物治疗组左股骨Ward区骨密度较治疗前有明显变化(P<0.01),左股骨L2-L4、Neck骨、GT部位的密度较治疗前轻微增加,但差异无显著意义,两治疗组间比较差异有统计学意义。骨量减少防治结束后3个月,针灸防治组L2-L4、股骨Neck、Ward区及GT骨密度值与药物组比较,差异均有统计学意义(P<0.05)。针灸和药物治疗骨质疏松症患者及针灸和药物防治骨量减少患者3个月后,BGP较治疗前均有不同程度降低(P<0.01),且针灸组与药物组BGP降低差异有统计学意义(P<0.05)。针灸和药物治疗组、针灸和药物防治组治疗后骨痛积分和衰老积分较治疗前降低(P<0.05,P<0.01),针灸治疗、防治组与药物组治疗、药物防治组治疗前后骨痛积分、衰老积分差值比较,差异有统计学意义(P<0.05,P<0.01)。针灸治疗组的临床控制率为25.0%、药物治疗组为3.25%,针灸防治组的临床控制率为35%,药防治物组为10%,针灸治疗、防治组疗效优于药物治疗、防治组(P<0.01,P<0.05)。结论:补肝肾健脾针法治疗骨质疏松症及防治骨量减少在提高骨密度、改善骨代谢、降低骨痛积分,改善衰老症状,改善临床症状上优于口服维丁钙片。该针灸疗法对防治原发性骨质疏松症及骨量减少,延缓衰老有明显的优势。     

基于BGP、TGF-β1的表达探究蛇床子素对去卵巢致骨质疏松大鼠的作用

目的观察蛇床子素对去卵巢致骨质疏松大鼠的影响。方法选取3月龄雌性SD大鼠30只,随机分为蛇床子素组(A组)、模型对照组(B组)、假手术组(C组),各10只。A、B 2组摘除卵巢构建去势大鼠骨质疏松模型,C组仅进行手术、不摘除卵巢。造模成功后,分别给予相应药物灌胃,连续给药12周,处死。然后测量骨密度,检测治疗后血清BGP、TGF-β1、钙指标。结果B组大鼠股骨骨密度较C组明显降低(P<0.05);经12周治疗,A组股骨骨密度较B组明显升高(P<0.05)。与C组比较,B组大鼠血清中BGP含量升高、TGF-β1降低(P<0.05);与B组比较,A组大鼠血清中BGP降低、TGF-β1含量升高(P<0.05)。与C组比较,B组大鼠血清Ca水平明显降低(P<0.05);与B组比较,A组大鼠血清Ca水平明显升高(P<0.05)。差异均有统计学意义。结论蛇床子素能够有效通过调节大鼠体内激素分泌改善去卵巢大鼠的骨代谢异常,提高骨密度,对骨质疏松症起到一定的防治作用。     

鹿胍多肽在治疗创伤性胸腰椎骨折中的作用机制

目的:探讨将鹿胍多肽应用于创伤性胸腰椎骨折的疗效及相关作用机制。方法:选取2014年4月至2017年4月青海大学附属医院收治的创伤性胸腰椎骨折患者167例,按照药物治疗措施不同分为对照组(n=82)和观察组(n=85)。对照组予以利塞膦酸钠单独给药治疗,观察组使用了利塞膦酸钠+鹿胍多肽联合用药方案治疗。比较应激反应指标Cor、NE、ALD、骨代谢BGP、PTH、BALP、C1CP等生化指标以及生活能力方面在治疗前后的变化幅度。结果:观察组BALP(26. 92±2. 67) pg/m L显著高于对照组,CTX(0. 33±0. 14) mg/m L、BGP(5. 71±1. 25)μg/L、P1NP(47. 33±4. 14) mg/m L、PTH(31. 38±3. 17) pg/m L、C1CP(7. 07±0. 91)μg/L显著低于对照组(P 0. 05);观察组AngⅠ(3. 38±0. 46) pg/m L、E(71. 46±3. 71) ng/m L、ALD(96. 92±5. 38) pg/m L、AngⅡ(31. 47±2. 75) pg/m L、显著低于对照组,NE(96. 71±4. 64) ng/m L、Cor(278. 87±12. 57) nmol/L显著高于对照组(P 0. 05);观察组在治疗后Barthel指数总分(43. 34±4. 15)分明显高于对照组(30. 83±3. 04)分(P 0. 05)。观察组临床总有效率为92. 94%,与对照组73. 17%比较,差异有统计学意义(χ2=3. 38,P 0. 05)结论:针对创伤性胸腰椎骨折患者骨组织修复的治疗,可给予鹿胍多肽作为辅助药物,鹿胍多肽具有降低患者应激反应,促进骨代谢修复的作用,提供患者生活能力。     

脑瘫患儿血骨钙素甲状旁腺素降钙素水平的观察

目的：研究脑瘫患儿血骨钙素（BGP）、甲状旁腺素（PTH）、降钙素（CT）的含量变化,分析它们与脑瘫病情、分型的关系。方法：应用放射免疫法测定37例脑瘫患儿和28例正常儿血清中的BGP、PTH、CT浓度。结果脑瘫组血清BGP明显高于正常组（P＜0．01）;重度脑瘫患儿PTH与正常组比较明显升高（P＜0．01）,而CT则低于正常组（P＜0．05）;同时发现痉挛型脑瘫患儿PTH含量高于手足徐动型,而CT则低于手足徐动型（P＜0．05）。结论：脑瘫患儿血清PTH、CT异常,其异常程度与脑瘫类型、病情轻重有关;血清BGP升高提示脑瘫患儿骨形成活跃。     

Serum markers of bone formation in parenteral nutrition patients

Summary Bone gamma-carboxyglutamic acid containing protein (BGP) has been utilized effectively as a serum marker of bone turnover in healthy normals and in individuals with a variety of metabolic bone disorders including postmenopausal osteoporosis and Paget's disease. The utility of this serum marker in other bone disorders, including that associated with the maintenance of patients on long-term parenteral nutrition, still requires definition. Because of our interest in this clinical syndrome and the availability of serum and of bone formation rates (BFR) measured directly from double tetracycline labeling in 11 long-term parenteral nutrition patients, we measured BGP levels in these patients and attempted to correlate this measure with BFR. Serum vitamin D metabolites, immunoreactive parathyroid hormone (PTH), and alkaline phosphatase (alk phos) were also measured. Serum BGP was only weakly and not significantly correlated (r=0.24, p=NS) with bone formation rate for the group as a whole. However, in a subgroup of 10 patients without hyperparathyroidism, there was strong and significant correlation (r=0.81,P<0.01) between BGP and BFR. There was also a strong correlation between bone formation rate and serum 1,25 dihydroxyvitamin D [1,25(OH)2D] levels (r=0.89,P<0.01, n=11). The mechanism of this association could not be established. A correlation of borderline significance was observed between bone formation rate and serum alk phos (r=0.60,P=0.05, n=11). The current data suggest that additional studies may help to more fully define the utility of serum measurements in quantifying bone dynamics in parenteral nutrition patients, and that measures of vitamin D metabolites, BGP, and alk phos may prove useful.     

辛伐他汀对正畸牙齿保持阶段骨形成的影响

目的:探讨全身给予辛伐他汀对大鼠正畸牙齿移动后保持阶段骨形成生化指标和骨密度的影响。方法:选用40只雄性Wistar大鼠,随机分成5组:基本对照组、阴性对照组(生理盐水)、低剂量组(2.5mg/kg)、中剂量组(5.0mg/kg)、高剂量组(10.0mg/kg),牵引其上颌第一磨牙向近中移动。实验组在加力装置去除前1d开始,腹膜下注射辛伐他汀;阴性对照组注射生理盐水,1次/d。4周后处死大鼠,取血,检测血清骨钙素(BGP)、碱性磷酸酶(ALP)、钙(Ca)、磷(P),测定上颌第一磨牙区牙槽骨密度(BMD)等。结果:实验组BGP、ALP水平较阴性对照组明显升高(P<0.05),低剂量组升高最明显,随剂量增加,BGP、ALP水平减低;实验组与对照组血清Ca、P无明显差别(P>0.05)。上颌第一磨牙区牙槽骨BMD对照组明显高于其它各组(P<0.05);实验组与阴性对照组比较,低剂量组最高,差异有显著性(P<0.05)。结论:辛伐他汀全身给药能够有效地促进局部牙槽骨骨合成代谢,最适有效剂量为2.5mg/kg。     

Effect of Glucocorticoids on Bone Gla Protein Values -BGP as a Good Marker of Osteoporosis-

It is important to prevent corticosteroid(CS)-induced osteoporosis, particularly in children. One of the mechanisms is a direct inhibitory effect of C S on osteoblasts. Bone Gla protein (BGP) is produced in osteoblasts, and the serum level of BGP reflects the bone formation rate. The aim of this study is to examine the usefulness of BGP as a marker of CS-induced osteoporosis. In the present study, serum levels of 24 pediatric patients who were given prednisolone (PSL) for long periods were studied in relation to their growth rate. Serum BGP was also determined in 167 healthy children and 16 adults. In healthy children, BGP levels reached a peak at the age of 15 years in boys and 11 years in girls. In patients who were given more than 0.25 mg/kg/day PSL, serum BGP levels were significantly decreased and height growth was remarkably suppressed. In conclusion, the measurement of serum BGP is useful for early detection of CS-induced osteoporosis.     

The spinal bone fracture of the aged women

The deformity or fracture of the spines, bone mineral density (BMD) of radius and spines by anterior-posterior scans and lateral scans, and metabolic bone markers were examined in the old women. The probability of fracture was less than 10% in women with L3 BMD over 0.786g/cm², and new fractures were not found during 12 months follow-up in these patients. Among the various metabolic parameters, bone Gla protein (BGP)/hydroxyproline (Hp) excretion ratio was one of the clinically useful indices if combined with BMD. The intensive therapy may not be necessary to patients with low BMD if they show high BGP/Hp ratio. Patients with low BMD and low BGP/Hp ratio should be treated intensively in the old women.     

老年糖尿病患者血清骨钙素与骨密度关系的研究

目的：研究老年糖尿病患者血清骨钙素（ＢＧＰ）水平与骨密度（ＢＭＤ）的关系。方法：应用放射免疫分析法（ＲＩＡ）对６０例老年Ⅱ型糖尿病患者与５０例健康老年人进行血清ＢＧＰ检测，并与ＢＭＤ、血清Ｃａ２＋、ＰＯ３－３和碱性磷酸酶（ＡＫＰ）进行比较和分析。结果：老年糖尿病组血清ＢＧＰ水平较对照组明显降低，并且糖尿病组血清ＢＧＰ的下降与ＢＭＤ的下降呈相关。结论：检测血清ＢＧＰ可以作为诊断老年糖尿病者骨代谢异常和骨质疏松的一项敏感而有用的指标