文章摘要
毕佳琦,张莹,杨琪,成勇,李宝林,孟庆刚.脉冲电磁场对废用性骨质疏松大鼠骨结构及骨代谢的影响[J].中华物理医学与康复杂志,2018,40(4):262-266
脉冲电磁场对废用性骨质疏松大鼠骨结构及骨代谢的影响
Pulsed electromagnetic field therapy can be used to treat osteoporosis
  
DOI:
中文关键词: 脉冲电磁场  骨质疏松,废用性  骨密度  骨生物力学
英文关键词: Pulsed electromagnetic fields  Osteoporosis  Bone mineral density  Bone biomechanics
基金项目:黑龙江省科技计划攻关资助项目(GCl0C303-4);哈尔滨市第一医院引进高层次人才基金项目(2014SYYRCYJ06-3、2013SYYRCYJ05-2);黑龙江省自然科学基金(H2016002)
作者单位
毕佳琦,张莹,杨琪,成勇,李宝林,孟庆刚 150001 哈尔滨哈尔滨市第一医院骨科(毕佳琦、杨琪、张莹、成勇、李宝林、孟庆刚)中国医学科学院北京协和医院-清华大学医学部研究生院(毕佳琦、杨琪) 
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中文摘要:
      目的 观察脉冲电磁场对废用性骨质疏松(DOP)大鼠的骨代谢以及生物力学性能的影响。 方法 健康4月龄雌性SD大鼠100只,按随机数字表法分成对照组、模型组、阿仑膦酸钠组(ALN组)和脉冲电磁场组(PEMF组),除对照组外,其余各组大鼠用胫骨-尾部固定法固定大鼠右后肢建立DOP模型,最终每组20只大鼠纳入实验研究。模型建立后,ALN组用阿仑膦酸钠[1mg/(kg·d)]灌胃治疗,PEMF组予以PEMF(3.82mT,10Hz)照射40min/d治疗,模型组和对照组则每日放入磁场装置中40min,但不打开磁场电源,以模拟治疗环境。分别于治疗后第2、4、8和12周,每组各处死5只大鼠,取右后肢股骨骨骼,测定骨密度后,应用万能电子试验机检测和记录各组大鼠右股骨的结构力学指标(最大负荷、最大位移、断裂能量)和材料力学指标(最大应力、最大应变和模量);采用免疫组化的方法检测右胫骨组织中的TNF-α和BMP-2蛋白表达。 结果 ①干预2周时,ALN组大鼠股骨骨密度高于模型组(P<0.05);干预4周和8周时,ALN组大鼠和PEMF组大鼠的骨密度值均高于模型组(P<0.05);干预第12周时,PEMF组大鼠骨密度值明显高于ALN组和模型组(P<0.05)。②干预2周时,与对照组比较,各组大鼠右股骨的最大负荷、最大位移、断裂能量、最大应力、最大应变及模量均下降(P<0.05);干预4周时,与对照组比较,各组大鼠股骨材料力学和结构力学指标均下降(P<0.05);ALN组右股骨的最大位移和最大负荷较模型组明显增高(P<0.05);干预8周时,ALN组右股骨的最大负荷、最大位移、断裂能量、最大应力均较模型组显著增高(P<0.01);而PEMF组与模型组比较,PEMF组结构力学指标增高(P<0.05),最大应变有所改善(P<0.01),其余各项指标差异均无统计学意义(P>0.05);干预12周时,ALN组与模型组比较,只有最大应力及最大应变明显改善(P<0.05),而PEMF组的所有力学指标均明显改善(P<0.05)。③与模型组比较,从干预第2周开始,ALN组和PEMF组的TNF-α均逐步下调;PEMF组和ALN组分别干预第2周开始BMP-2蛋白的表达均升高(P<0.05),但其升高并不同步,干预第8周后,PEMF组BMP-2蛋白的升高开始显著高于ALN组(P<0.01)。 结论 PEMF与阿仑膦酸钠均可以抑制骨量的丢失,但PEMF的作用较为温和持久。
英文摘要:
      Objective To observe the effect of a pulsed electromagnetic field (PEMF) on the bone structure and metabolism of rats with disuse osteoporosis (DOP). Methods One hundred 4-month-old female Sprague-Dawley rats were randomly divided into a control group (INT group), an osteoporosis model group (DOP group), a sodium alendronate group (ALN group) and a pulsed electromagnetic field group (PEMF group), each of 25. The right hind-limbs of the rats in the DOP, ALN and PEMF groups were immobilized by tibia-tail fixation for two weeks to establish a DOP model. The rats in the ALN group were given 1 mg/kg of sodium alendronate once a day, while those in the PEMF group received PEMF at 3.82 mT and 10 Hz with a pulse time of 8 ms for 40 min/d. Five rats in each group were sacrificed at the 2nd, 4th, 8th and 12th week and their right hind-limbs were separated to measure the bone mineral density (BMD), structural mechanics indexes (the maximum load, maximum displacement and rupture energy) and material mechanics indexes (maximum stress, maximum strain and modulus). Moreover, the expression of tumor necrosis factor alpha (TNF-α) and bone morphogenetic protein 2 (BMP-2) were detected using immunohistochemical methods. Results The average BMD of the model group was significantly lower than that of the ALN group after 2 weeks, and lower than that of the PEMF group after 4 and 8 weeks. After 12 weeks the average BMD of the PEMF group was significantly higher than that of the ALN and model groups. After two and four weeks, all the structural and material mechanics measurements had decreased significantly compared with those of the control group. The average maximum displacement and load of the ALN group had increased significantly compared with the model group after 4 weeks of treatment. After 8 weeks the average maximum load, maximum displacement, rupture energy and maximum stress of the ALN and PEMF groups had increased significantly compared with the model group. Compared with the model group, the average level of TNF-α decreased gradually in both the ALN and PEMF groups from the 2nd week on, while that of BMP-2 increased from the same time point. However, at the 8th week the expression of BMP-2 protein in the PEMF group was on average significantly higher than in the ALN group. Conclusion Both PEMF and sodium alendronate can increase bone density, but PEMF has more persistent effects.
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