血管内皮生长因子在骨折愈合中的作用

目的　研究血管内皮生长因子 (VEGF)在骨折愈合过程中的作用 ,探讨应用 VEGF及拮抗VEGF对骨折愈合所产生的影响。方法　利用新西兰大耳白兔 10 5只制作左侧桡骨中段骨折动物模型 ,随机分成三组 ,两组分别应用 VEGF多克隆抗体及 VEGF,另一组为对照组 (不作任何处理 )。在伤后 8、2 4、72小时和 1、3、5、8周利用单光子放射计算机断层显像术测定骨折端血流量变化 ,在 1、3、5及 8周摄 X线片观察骨折愈合情况。结果　应用 VEGF使骨折端血流量在 8小时～ 3周较对照组增高 ,但 X线片却未见明显差异 ;而 VEGF多克隆抗体可导致骨折端血流量在各时相点较对照组明显减少 ,并阻碍了骨折的愈合进程 ,最终使骨折端形成骨不连样改变。结论　骨折愈合过程中缺乏 VEGF将严重影响骨折的正常愈合过程 ,并导致骨不连接 ,应用外源性 VEGF可能通过增加骨折端血流量而对骨折愈合有益

EFFECT OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN FRACTURE HEALING

Objective To observe the effect of vascular endothelial growth factor (VEGF) in fracture healing and to investigate the influence of VEGF and VEGF antibody in fracture healing. Methods One hundred and five rabbits were used to make fracture model in the left radius and randomly divided into control group, VEGF group and VEGF antibody group. VEGF and VEGF antibody were used in the VEGF group and VEGF antibody group respectively, then the blood flow of the fracture ends was measured by single photon emission computed tomography (SPECT) 8, 24 , 72 hours, 1, 3, 5 and 8 weeks after fracture, the X ray films of the fracture sites were taken after 1, 3, 5 and 8 weeks to observe the fracture healing. Results The blood flow of the fracture ends in the VEGF group increased during a period from 8h to 3wk after fraction when compared with that of the control group, and no obvious difference was seen on the X ray films between the two groups. In the VEGF antibody group, the blood flow of the fracture ends decreased obviously when compared with that of the control group. The fracture healing process was interfered seriously and nonunion change was seen in the fracture site. Conclusion The lack of VEGF will interfere with the fracture healing process and result in nonunion in the fracture site. Administration of ectogenous VEGF may promote fracture healing by increasing the blood flow of the fracture ends.