骨形态发生蛋白2 在人骨不连组织中的表达及其临床意义

目的：探讨肥大性骨不连组织与萎缩性骨不连组织在成骨潜能上的差异，进一步指导骨不连的治疗。方法：收集2010年10月至2014年3月入住中南大学湘雅二医院骨科的骨不连患者骨不连处组织40例，按照骨不连性质分为肥大性骨不连组(n=20)、萎缩性骨不连组(n=20)；按照不同年龄段分为20~35岁年龄组(n=18)、36~50岁年龄组(n=18)、>50岁年龄组(n=4)；按照骨不连时间分为9~12个月组(n=21)、13~24个月组(n=14)和>24个月组(n=5)。利用免疫组织化学SP二步法及IPP6.0病理图像分析软件对骨不连组织中骨形态发生蛋白-2(bone morphogenetic protein-2，BMP-2)的表达进行半定量分析，测定其平均吸光度值。结果：肥大性骨不连组BMP-2平均吸光度值为0.1540±0.0408，萎缩性骨不连组BMP-2平均吸光度值为0.1372±0.0372，两组标本BMP-2平均吸光度值差异无明显统计学意义(P>0.05)。20~35岁年龄组BMP-2平均吸光度值为0.1477±0.0379，36~50岁年龄组BMP-2平均吸光度值为0.1419±0.0399，>50岁年龄组BMP-2平均吸光度值为0.1456±0.0595，三组年龄段标本间BMP-2平均吸光度值差异无明显统计学意义(P>0.05)。在三组不同骨不连时间中，9~12个月组BMP-2的平均吸光度值为0.1449±0.0366，13~24个月组BMP-2的平均吸光度值为0.1472±0.0400，>24个月组BMP-2的平均吸光度值为0.1445±0.0541，三组不同骨不连时间标本之间BMP-2平均吸光度值差异亦无明显统计学意义(P>0.05)。结论：肥大性骨不连组织和萎缩性骨不连组织在成骨潜能上无显著性差异。

Expression of bone morphogenetic protein 2 in human nonunion tissue and the clinical significance

Objective: To explore the difference of bone formation potential between hypertrophic nonuniontissue and atrophic nonunion tissue, which may be beneficial to nonunion therapy.Methods: From October 2010 to March 2014, 40 nonunion tissue samples were collectedin Department of Orthopedics, Second Xiangya Hospital. The samples were divided into ahypertrophic nonunion group (n=20) and an atrophic nonunion group (n=20) according tononunion character; or a 20 to 35 years old group (n=18), a 36 to 50 years old group (n=18), amore than 50 years old group (n=4) according to different ages; or a 9–12 months group (n=21),13–24 months group (n=14) and a more than 24 months group (n=5) according to differentnonunion time. Semi-quantification was performed by SP immunohistochemical method andIPP6.0 was used to analyze the expression of bone morphogenetic protein-2 (BMP-2) throughmeasuring the mean optical density.Results: The mean optical density of BMP-2 was 0.1540±0.0408 in hypertrophic nonunion tissue,0.1372±0.0372 in atrophic nonunion tissue, there was no significant difference between the 2groups (P>0.05). The mean optical density of BMP-2 was 0.1477±0.0379 in the 20 to 35 yearsold group, 0.1419±0.0399 in the 35 to 50 years old group, 0.1456±0.0595 in the more than 50years old group, there was no significant difference among the three groups (P>0.05). The meanoptical density of BMP-2 was 0.1449±0.0366 in the 9–12 months group, 0.1472±0.0400 in the13–24 months group, 0.1445±0.0541 in the more than 24 months group, there was no significantdifference among the 3 groups (P>0.05).Conclusion: The present results suggest that the hypertrophic nonunion tissue share similarosteogenic potential with the atrophic nonunion tissue.