摘要目的 探索能够在短期内有效提高骨质疏松椎体骨强度的局部治疗方法.方法 采用卵巢切除法(OVX)对6只成年雌性绵羊去势,低钙饲养1年后,经双能X线吸收骨密度测量仪检测后确定建立骨质疏松模型.采用拉丁方设计方案,通过经椎弓根注射途径,分别在每只动物的L4～L6注射三种药物:实验组A注射20 mg bBMP/FS,对照组B注射20 mg bBMP,对照组C单纯注射FS.L3椎体设为空白对照组D.术后3个月,采用骨密度测量仪和MicroCT对绵羊腰椎骨密度及骨小梁微观结构进行分析比较.通过轴向加压实验对腰椎标本进行生物力学测定,对椎体力学性能进行评估.结果 绵羊去势1年后,腰椎骨密度平均下降20.6%,动物模型成功建立.接受实验处理3个月后,实验组A骨密度(1.334 g/cm2)明显高于对照组B、C及D组骨密度(1.139 g/cm2,1.163 g/cm2和1.177 g/cm2).MicroCT分析表明:实验组骨小梁的密度、连接率均显著高于对照组.生物力学研究表明实验组A最大压缩应力、最大压缩应变、能量吸收值及骨质弹性模量均明显高于对照组B、C及D组.结论 bBMP复合纤维蛋白胶可以促进骨小梁的改建,改善骨小梁的三维结构,增加椎体的骨密度及骨强量,可以作为局部治疗脊柱骨质疏松的新型方法之一.

abstractsObjective To investigate a local treatment method which can improve the mechanical strength in osteopenic vertebra rapidly.Methods Six sheep underwent ovariectomy(OVX)and were placed on One vear of low-calcium diet.All sheep underwent BMD scan at the time of OVX and one year later toensure the establishment of osteoporosi's.Sheep were randomly assigned to three treatment groups.Accordingto the ladin square design,20 mg bBMP/fibrin sealant(FS)(Group A),20 mg bBMP(Group B)and FS (Group C)were injected into L4-L6 vertebra respectively.k was selected as blank control(Group D).The BMD and micro-architecture of vertebrae were measured by dural energy X-ray absorption meter and microCT 3 months after injection.Axial compression tests were carried out on vertebral specimens to evaluate their mechanical strength.Results The mean BMD of lumbar spine decreased by 20.6%one year after OVX.The sheep could be considered as animal model of osteoporosis.After injected BMP/FS,the BMD in Group A(1.334 g/cm2)was significantly higher than Group B(1.139 g/cm2),Group C(1.163 g/cm2)and Group D(1.177 g/cm2).The MicroCT reconstruction analysis also showed that the density and connectivity of trabecular bone in group A were higher than group B,C,D.The results of biomechanical test showed that the maxium compression strength,the maxium compression strain,engery absorbtion and modules in group A were significantly higher than the group B,C,D.Conclusion Local bovine BMP combined with fibrin sealant treatment showed a positive trend in improving mechanical strength and structure of osteopenic vertebra,consistent with BMD.The data suggest that the use of Bovine BMP combined with fibrin sealant in the local treatment of vertebral osteoporosis.