白硕,王冬香,朱鹏娜,唐正龙
BAI Shuo,WANG Dongxiang,ZHU Pengna,TANG Zhenglong

• 1:贵州医科大学附院口腔颌面外科
• 2:杭州市口腔医院

摘要(Abstract)：

目的:研究不同剂量重组人甲状旁腺素(rh PTH)对下颌骨牵张成骨新骨形成及质量的影响。方法:日本大耳白兔45只,随机均分为对照组和实验A、B、C、D组,在前牙和第一磨牙交界处垂直于下颌骨下缘,用慢速裂钻作截骨线,牵张延长下颌骨10 mm,对照组动物隔日皮下注射生理盐水1 m L,实验A、B、C及D组分别隔日皮下注射rh PTH 10、20、30、40μg/kg,在固定期第1、7及14天时行牵张区新骨组织形态学研究和骨密度检测。结果:各固定期实验组的成骨细胞数量、骨小梁面积和骨密度均较高,与对照组比较差异有统计学意义(P<0.05);在固定期第1天时实验C组的平均成骨细胞数量和骨密度最高,随固定期延长,各组新骨骨密度和骨小梁面积逐渐升高,而成骨细胞数量逐渐减少。结论:间断皮下注射rh PTH可以促进下颌骨牵张成骨新骨生成,不同剂量rh PTH促进下颌骨牵张成骨可能存在剂量效应差异。
Objective: To investigate the effects of parathyroid hormone(PTH) on new bone formation during mandibular distraction osteogenesis( DO). Methods: Forty-five Japnese rabbits were divided into control group,receiving a subcutaneous injection of 1 ml of saline every other day and experimental groups A,B,C and D,receiving subcutaneous injections of 10,20,30 and 40 μg / kg of rh PTH,respectively,every other day. On the 1st,7th,14 thday of the consolidation period after the mandibular distraction had been completed,new bone in the distraction region was examined through histomorphometric investigation and bone mineral density( BMD) was detected. Results: On the 1st,7th,14 thday of the fixation period,number of osteoblasts,trabecular bone area and BMD were significantly greater in each experimental group than their counterparts in control group( P < 0. 05). On 1st day of the consolidation period,the average gnumber of osteoblasts and BMD in group C were highest.With the fixation period to extend,in each experimental group,BMD of new bone and trabecular bone area increased gradually while number of osteoblasts decreased. Conclusions: Intermittent subcutaneous injections of rh PTH can promote new bone formation during mandibular DO. Different doses of rh PTH can promote mandibular DO and there may exist differences in dose effect.

关键词(KeyWords)： 重组人甲状旁腺素;牵张成骨;下颌骨;骨密度;成骨细胞
recombinant human parathyroid hormone;distraction osteogenesis;mandible;bone mineral density;osteoblast

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(No:81160130)

作者(Author): 白硕,王冬香,朱鹏娜,唐正龙
BAI Shuo,WANG Dongxiang,ZHU Pengna,TANG Zhenglong

DOI: 10.19367/j.cnki.1000-2707.2016.02.006

参考文献(References)：

• [1]Dempster DW,Cosman F,Parisien M,et al.Anabolic actions of parathyroid hormone on bone[J].Endocr Rev,1993(6):690-709.
• [2]Uzawa T,Hori M,Ejiri S,et al.Comparison of the effects of intermittent and continuous administration of human parathyroid hormone(1-34)on rat bone[J].Bone,1995(16):477-484.
• [3]Chen H,Frankenburg EP,Goldestein SA,et al.Combination of local and systemic parathyroid hormone enhances bone regeneration[J].Clin Orthopaed Relat Res,2003(416):291-302.
• [4]Kim T.Brixen,Palle MC,et al.Teriparatide(Biosynthetic Human Parathyroid Hormone 1-34):A new paradigm in the treatment of osteoporosis[J].Basic&Clinical Pharmacology&Toxicology,2004(94):260-270.
• [5]Obermayer-Pietsch BM,Marin F,Mc Closky EV,et al.Effects of two years of daily teriparatide treatment on bone mineral density in postmenopausal women with severe osteoporosis with and without prior antiresorptive treatment[J].J Bone Miner Res,2008(10):1591-1600.
• [6]Aspenberg P,Genant HK,Johansson T,et al.Teriparatide for acceleration of fracture repair in humans:a prospective,randomized,double-blind study of 102 postmenopausal women with distal radial fractures[J].J Bone Miner Res,2010(2):404-414.
• [7]Alkhiary YM,Gerstenfeld LC.Krall E,et al.Enhancement of experimental fracture-healing by systemic administration of recombinant human parathyroid hormone(PTH1-34)[J].J Bone Joint Surg Am,2005(4):731-741.
• [8]Rowshan HH,Parham MA,Baur DA,et al.Effect of intermittent systemic administration of recombinant parathyroid hormone(1-34)on mandibular fracture healing in rats[J].J Oral Maxillofac Surg,2010(68):260.
• [9]Aleksyniene R,Eckardt H,Bundgaard K,et al.Effects of parathyroid hormone on newly regenerated bone during distraction osteogenesis in a rabbit tibial lengthening model[J].A pilot study Medicina,2006(1):38-48.
• [10]Aleksyniene R,Thomsen JS,Eckardt H,et al.Threedimensional microstructural properties of regenerated mineraling tissue after PTH(1-34)treatment in a rabbit tibial lengthening model[J].J Musculoskelet Interact,2009(4):268-277.
• [11]Aleksyniene R,Thomsen JS,Eckardt H,et al.Prarathyroid hormone PTH(1-34)increases the volume,mineral content,and mechanical properties of regenerated mineralizing tissue after distraction osteogenesis in rabbits[J].Acta Orthopaedica,2009(6):716-723.
• [12]Ali MN,Kobayashi T,Tanaka M,et al.Effects of intermittent parathyroid hormone treatment on new bone formation during distraction osteogenesis in the rat mandible[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2012(1):36-42.
• [13]Seebach C,Skripitz P,AndreassenT T,et al.Intermittent parathyroid hormone(1-34)enhance mechanical strength and density of new bone after distraction osteogenesis in rats[J].Orthop Res,2004(3):472-478.
• [14]Chan HL,McC auley LK.Parathyroid hormone applications in the craniofacial skeleton[J].J Dent Res,2013(1):18-25.
• [15]Cheung A,Seeman E.Teriparatide therapy for alendronate-associated osteonecrosis of the jaw[J].N Engl J Med,2010(25):2473-2474.
• [16]Valderrama P,Jung RE,Thoma DS,et al.Evaluation of parathyroid hormone bound to a synthetic matrix for guided bone regeneration around dental implants:a histomorphometric study in dogs[J].J Periodontol,2010(5):737-747.
• [17]Bashutski JD,Eber RM,Kinney JS,et al.Teriparatide and osseous regeneration in the oral cavity[J].N Engl JMed,2010(25):2396-2405.
• [18]Nakajima A,Shimoji N,Shiomi K,et al.Mechanisms for the enhancement of fracture healing in rats treated with intermittent low-dose human parathyroid hormone(1-34)[J].J Bone Miner Res,2002(11):2038-2047.
• [19]Aslan D,Andersen MD,Gede LB,et al.Mechanisms for the bone anabolic effect of parathyroid hormone treatment in humans[J].Scand J Clin Lab Invest,2012(1):14-22.
• [20]Tang ZL,Zhang WJ,Wang DX,et al.An experimental study addressing the promotion of mandibular defect repair through the intermittent subcutaneous injection of parathyroid hormone[J].J Oral Maxillofac Surg,2014(2):419-430.

文章评论(Comment)：