中国伤残医学2024，Vol.32Issue(2)：10-14,5.DOI:10.13214/j.cnki.cjotadm.2024.002.003
糖尿病患者骨不连断端组织中成骨活性的差异性研究
The Difference of Osteogenic Activity in Nonunion Broken end Tissue of Diabetic Patients
摘要
Abstract
Objective:To investigate the osteogenic activity of nonunion broken end tissue in patients with diabetes,and to provide reference for improving the quality of fracture healing in patients with diabetes.Methods:60 elderly AO/OTA type 1 fracture patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University from June 2021 to June 2022 undergoing closed reduction and intramedullary nail-fixation of middle and lower tibial fractures were selected as the study objects.According to the diagnostic criteria of type 2 diabetes set by the World Health Organization(WHO).Patients were divided into type 2 diabetes group(n=27)and non-diabetes group(n=33).After treatment,X-ray films were taken at the fracture area to observe the osteogenic changes at the broken end of the two groups,and the incidence of bone nonunion was calculated.The fracture healing was evaluated based on Lane-Sandhu X-ray scoring criteria.The broken end tissues of the two groups of non-union patients were biopsied to observe the bone morphology,and the staining of bone morphogenetic protein-2(BMP-2),core proteoglycan(DCN)and fibroblast growth factor(BFGF)were detected by immunohistochemistry,and the average gray value was calculated.Results:The incidence of bone nonunion in type 2 diabetes group was higher than that in non-diabetes group,and Lane-Sandhu X-ray score was lower than that in control group,with statistical significance(P<0.05).The histomorphology of nonunion patients is mainly characterized by fibrous scar tissue in the center of the broken end,and braided bone and neovascularization are rare.Immunohistochemical test results showed that the staining positive rate and mean recovery value of bone growth factor BMP-2,DCN and BFGF in type 2 diabetes group were lower than those in non-diabetes group,and the differences were statistically significant(P<0.05).Conclusion:In fracture patients with diabetes mellitus,the osteogenic activity of broken end tissue is not high,which is prone to nonunion and poor osteogenic quality,which may be related to the low expression of BMP-2,DCN and BFGF in the broken end tissue of nonunion.Osteogenesis induced by bone growth factors is expected to improve the quality of fracture healing in diabetic patients,prevent and reduce bone nonunion.关键词
糖尿病/骨不连/成骨活性/骨生长因子Key words
Diabetes mellitus/Nonunion of bones/Osteogenic activity/Bone growth factor分类
医药卫生引用本文复制引用
刘伟,张翠影,杨帆,栾富均,何盛江,赵强..糖尿病患者骨不连断端组织中成骨活性的差异性研究[J].中国伤残医学,2024,32(2):10-14,5.基金项目
重庆市永川区自然科学基金项目(Ycstc,2020nb0246) （Ycstc,2020nb0246）
