本文關(guān)鍵詞： 骨壞死 放射性 頜 模型 動(dòng)物 纖維化 骨組織形態(tài)學(xué)分析　出處：《中華口腔醫(yī)學(xué)研究雜志(電子版)》2016年01期 　論文類型：期刊論文

【摘要】：目的依據(jù)頜骨放射性骨壞死(ORNJ)新的臨床診斷標(biāo)準(zhǔn),探討建立可模擬ORNJ不同臨床分期的復(fù)合型動(dòng)物模型的方法。方法健康SD雄性大鼠36只,隨機(jī)分為6組:a1、b1、c1為實(shí)驗(yàn)組,a0、b0、c0組為對(duì)照組;根據(jù)生物學(xué)等效公式,實(shí)驗(yàn)組采用電子直線加速器對(duì)大鼠左側(cè)下頜區(qū)進(jìn)行照射,7Gy/次,1次/d,照射5 d;照射后6周,處死a1、a0組大鼠,并拔除b1、b0、c1、c0組大鼠左側(cè)下頜磨牙;照射12、18周后,分別處死b1、b0組大鼠和c1、c0組大鼠并取下頜骨標(biāo)本。對(duì)所有標(biāo)本進(jìn)行組織學(xué)觀察和micro-CT掃描與骨組織形態(tài)學(xué)分析。使用SPSS 18.0軟件包對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果實(shí)驗(yàn)組照射區(qū)可見a1組門齒生長(zhǎng)障礙、b1組死骨暴露、c1組咬合錯(cuò)亂,化膿性感染與病理性骨折等癥狀;對(duì)照組無(wú)癥狀。組織學(xué)觀察可見,實(shí)驗(yàn)組照射區(qū)骨髓腔與牙周膜內(nèi),炎性細(xì)胞浸潤(rùn)、纖維組織增生,b1、c1組還可見游離死骨;實(shí)驗(yàn)組門齒牙根與皮質(zhì)骨漸進(jìn)性破壞,c1組部分大鼠門齒牙根結(jié)構(gòu)消失,周圍皮質(zhì)骨不連續(xù);實(shí)驗(yàn)組空白骨陷窩增多,骨陷窩內(nèi)骨細(xì)胞減少。micro-CT結(jié)果顯示:相對(duì)骨體積(BV/TV):a1(0.401±0.053)、a0(0.615±0.037)、b1(0.309±0.041)、b0(0.717±0.040)、c1(0.200±0.026)、c0(0.724±0.041),實(shí)驗(yàn)組相對(duì)骨體積(BV/TV)均低于對(duì)照組;實(shí)驗(yàn)組間BV/TV值相比,a1b1c1,Pa1、b1=0.012、Pb1、c1=0.034、Pc1、a1=0.004,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論建立了一種能夠模擬出輕度無(wú)癥狀(a1)、中度死骨暴露(b1)與重度聯(lián)合癥狀(c1)三種不同ORNJ分型的復(fù)合型動(dòng)物模型,為針對(duì)性研究ORNJ治療方法提供了實(shí)驗(yàn)平臺(tái)。
[Abstract]:Objective according to the new clinical diagnostic criteria of osteonecrosis of jaws (ORNJ), to explore the method of establishing compound animal model which can simulate different clinical stages of ORNJ. Methods 36 healthy male SD rats were used. The rats were randomly divided into 6 groups: the control group was the control group (n = 6). According to the biological equivalent formula, the experimental group irradiated the left mandibular region of rats with electron linear accelerator for 7 Gy / once a day for 5 days. Six weeks after irradiation, the rats in group A were killed and the left mandibular molars of group B 1 were extracted. After 12 weeks of irradiation, the rats in group B _ (1) were killed, and the rats in group C _ (1) were killed. The mandibular specimens were taken from c0 group rats. Histological observation, micro-CT scanning and bone histomorphology analysis were performed on all the specimens. SPSS was used. The data were analyzed by 18.0 software package. Results in the irradiated area of experimental group, the growth disorder of gentgear was found in group A1. Group B 1 was exposed to dead bone, and the symptoms of occlusal dislocation, suppurative infection and pathological fracture were found in group C1. The control group was asymptomatic. Histological observation showed that free dead bone could be seen in experimental group (n = 10). In experimental group, inflammatory cells were infiltrated in the medullary cavity and periodontal ligament in the irradiated area, and free dead bone was found in group B _ 1C _ 1 of fibrous tissue proliferation. The incisor root and cortical bone were destroyed gradually in the experimental group. Some of the incisor root structure disappeared and the cortical bone was discontinuous in the experimental group. In the experimental group, the number of empty bone lacunae increased, and bone cells decreased. Micro-CT results showed that the relative volume of bone was 0.401 鹵0.053. A 0. 615 鹵0. 037 B1 + 0. 309 鹵0. 041 and 0. 717 鹵0. 040 ~ 0. 00.200 鹵0. 026). The relative bone volume (BV / TVV) of the experimental group was lower than that of the control group (0. 724 鹵0. 041 鹵0. 024 鹵0. 041). The BV/TV value of the experimental group was 0.012 Pb1 / c1 ~ (1) and 0.034 ~ (4) Pc1C ~ (1 +) ~ (1) ~ 0. 004, compared with that of the control group. The difference was statistically significant (P 0.05). Conclusion A kind of mild asymptomatic analogue was established. The combined animal models of moderate dead bone exposure (b1) and severe syndromes (c1) were divided into three different types of ORNJ, which provided an experimental platform for the study of ORNJ therapy.
【作者單位】： 第四軍醫(yī)大學(xué)口腔醫(yī)院口腔頜面外科;
【基金】：國(guó)家自然科學(xué)基金(81202150/H2201) 陜西省社會(huì)發(fā)展科技攻關(guān)項(xiàng)目(2015SF140)
【分類號(hào)】：R730.55;R782;R-332
【正文快照】： 放射治療是頭頸部惡性腫瘤治療的有效手段,但可造成各種并發(fā)癥,其中以頜骨放射性骨壞死(osteoradionecrosis of jaws,ORNJ)最為嚴(yán)重,其發(fā)病率約為8.2%~22%[1]。目前,ORNJ的診斷尚無(wú)統(tǒng)一標(biāo)準(zhǔn),普遍認(rèn)為ORNJ是在無(wú)腫瘤復(fù)發(fā)或殘余的情況下,受照射區(qū)域骨組織暴露于皮膚或黏膜外,超

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