脑外伤后胰岛素样生长因子-Ⅰ及血小板衍生生长因子对骨折愈合的影响

目的研究大鼠股骨骨折合并脑外伤时血清胰岛素样生长因子-Ⅰ(IGF-Ⅰ)和血小板衍生生长因子(PDGF)水平,探讨IGF-Ⅰ和PDGF与骨折合并脑外伤时愈合加快的关系。方法将152只大鼠分为4组:A组(正常对照组)、B组(脑外伤组)、C组(骨折组)和D组(骨折合并脑外伤组),其中A组8只,B、C、D组各48只。建立大鼠脑外伤和骨折模型,分别于术后1d、4d、1周、2周、3周和4周取血清,酶联免疫吸附法(ELISA)测血清中IGF-Ⅰ和PDGF浓度。结果实验期间C组IGF-Ⅰ的血清浓度无明显变化,围绕A组IGF-Ⅰ的血清浓度水平上下波动,B组和D组的变化趋势趋于一致,两组在各个时间点上相比较差异无统计学意义。1d时,B组和D组IGF-Ⅰ的血清浓度较其余两组明显增加(P<0.01),4d时达到峰值,B、D两组与其余两组比较差异有统计学意义(P<0.01),1周和2周时B、D两组IGF-Ⅰ的血清浓度逐渐下降,与其余两组比较差异有统计学意义(P<0.01),3周和4周时B、D两组IGF-Ⅰ的血清浓度基本降至A组水平,各组相比差异无统计学意义(P>0.05)。在1d至1周时间段内,各时间点B组、C组和D组PDGF的血清浓度均较A组降低,以D组降低最为明显,与其余各组相比差异均有统计学意义(P<0.01),B组和C组与A组相比降低(P<0.01),在2周和4周时间点上,B组和C组PDGF的血清浓度基本回升至A组水平,与A组比较差异无统计学意义(P>0.05),D组与其他3组比较差异有统计学意义(P<0.01)。结论IGF-Ⅰ和PDGF可能是脑外伤后骨折愈合加快的原因之一,且两者之间可能有协同作用。

Study on the Effects of Insulin-like Growth Factor(IGF-Ⅰ) and Platelet-derived Growth Factor(PDGF ) on Fracture Healing after Traumatic Brain Injury

Objective To investigate the levels of serum IGF-Ⅰ and PDGF and the role they played in healing of femoral fracture complicating cerebral trauma.Methods One hundred and fifty-two rats were divided into four groups randomly.They were group A,negative control;group B,cerebral traumas;group C,fracture of femur;and group D fracture of femur complicating cerebral trauma.Rat models with femoral fracture and cerebral trauma were established and blood serum collected at day 1,4,week 1,2,3 and 4 after the operations.The levels of IGF-Ⅰ and PDGF were detected by ELISA method.Results The concentrations of IGF-Ⅰ in group C had not changed significantly.The IGF-Ⅰ in group B and D changed more significantly(P<0.01).They increased positively in the first day and the maximum value was detected after four days,and decreased gradually in two weeks,however still much higher than those in groups A and C(P<0.01).After four weeks,the levels in groups B and D declined to that in group A and there was no statistical difference among those four groups then.At the first day,the PDGF levels in group B,C and D were lower than that in group A(P<0.01).Two weeks later,the PDGF levels in groups B and group C decreased to the same level as that in group A.However,there was statistical difference between group D and the other three groups(P<0.01).Conclusion The levels of IGF-Ⅰ and PDGF in serum may be involved in the fast healing process of femoral fracture complicating cerebral trauma,and there may be a synergetic relationship between IGF-Ⅰ and PDGF.