成肌细胞介导的hIGF-1基因转移促小鼠胫骨骨折愈合作用的实验研究-骨外科学专业论文.docxVIP

周曾注射转hIGF-1基因成肌细胞和生理盐水的肌肉行BrdU和hIGF-1免疫组织化学染色分 析外源性细胞在体内有无存活并表达hIGF-1，并用HMIAS-2000高清析度彩色医学图文分析 系统对IGF-1蛋白表达进行半定量检测，其结果以平均灰度值表示，平均灰度值低示表达 水平高；左胫骨行X线摄片以观察骨折愈合情况；骨痂采用透射电镜观察生长情况。 结果：各实验组转基因成肌细胞BrdU和hIGF-1免疫组化染色均阳性，各对照组BrdU和 hIGF-1免疫组化染色均阴性，4周实验组平均灰度值虽稍高于2周实验组，但经独立样本t 检验P0.05,差异无显著性；所有实验组外骨痂中小梁骨占骨痂总面积的百分比均高于对 照组，其中第3、4周经F检验两组的差异具有显著性（P0.05）；X线显示第4周实验组有 较多骨痂形成，经秩和检验与对照组有显著差异（P0.05）；电镜显示实验组骨生成细胞 的数量、活跃程度和胶原纤维的数量、分布均优于对照组。 结论：1、携hIGF-1基因的成肌细胞移植入C57BL/6J小鼠胫骨骨折处周围肌肉中可存活 4周以上,并能稳定地分泌hIGF-1；2、局部注射转hIGF-1基因的成肌细胞可以促进C57BL/6J 小鼠胫骨骨折的愈合；3、我们推测局部注射的转hIGF-1基因成肌细胞可能是通过内分泌 和（或）旁分泌提高C57BL/6J小鼠血清和（或）骨折局部的IGF-1浓度从而达到促进胫骨 骨折愈合的作用。 关键词：胰岛素样生长因子-1；成肌细胞；骨折愈合；小鼠 ABSTRACT Background：Approximately 5 to 10% of bone fractures cases are associated with delayed union or non-union.Thus,how to enhance the fracture repair process, normalize the rate of healing,and decrease the likelihood of nonunion has garnered considerable interest from academia. The gold standard for attaining bony union in non-unions is autologous bone graft.However,harvesting this graft is not without complications:multiple surgical sites and incisions lead to a decrease in weight bearing status and function,and to an increase in blood loss,operative time,risk of fracture,risk of infection, and pain. Furthermore,autograft does not necessarily lead to fusion. These complications underscore the need to understand the molecular and cellular events critical to bone formation,and to develop innovative strategies to enhance bone regeneration. Fracture repair can be envisioned as involving five distinguishable processes, including the immediate response to injury 、 intramembranous bone formation 、 chondrogenesis、 endochondral bone formation leading to the reestablishment of load bearing function, and bone remodeling. During fracture repair, a number of growth factors, cytokines, and their cognate receptors are present at elevated levels in and around the fracture site.Many of these proteins are normally expressed in skeletal tissue, an