向乐 余伟

[摘要] 目的 探讨丹参注射液对大鼠下颌骨骨折愈合的影响，并通过测量骨形成蛋白-2（BMP-2）、转化生长因子-β1（TGF-β1）水平变化，探讨丹参促进下颌骨骨折愈合的機制。 方法 选取SD大鼠48只，通过双侧下颌骨体部造成颊舌侧贯穿不完全性骨折模型，按随机数字表法分为实验组和对照组，每组24只。实验组每天腹腔注射丹参注射液（1 mL/kg），对照组每天腹腔注射生理盐水。术后第1、2、3、4周，每组分别随机处死6只大鼠，采用酶联免疫吸附试验（ELISA）检测血清BMP-2、TGF-β1的含量。取出双侧下颌骨，右侧下颌骨行X线片检测骨折愈合情况并测量骨痂区的平均骨密度，标本经组织脱钙、石蜡包埋行HE染色后，采用骨组织形态计量学方法分析骨痂区骨小梁面积比、骨小梁宽度；左侧下颌骨骨痂，行组织粉碎，采用RT-qPCR技术检测BMP-2、TGF-β1的表达情况。 结果 X线结果显示对照组骨折愈合明显延迟于实验组；从第2周开始，与对照组相比，实验组骨痂骨密度明显增加（P < 0.05或P < 0.01），骨痂区骨小梁面积比、骨小梁宽度显著性增大（P < 0.05或P < 0.01）；差异随着愈合时间的延长而显著。ELISA结果显示，术后实验组血清BMP-2、TGF-β1的浓度均高于对照组（P < 0.05）。RT-qPCR结果显示，术后第2周开始，实验组骨痂中BMP-2及TGF-β1mRNA的表达均高于对照组（P < 0.01）。 结论 丹参注射液促进下颌骨骨折愈合，可能与促进骨折愈合过程中BMP-2、TGF-β1基因的转录及蛋白表达有关。

[关键词] 丹参注射液；下颌骨骨折；骨形成蛋白-2；转化生长因子-β1

[中图分类号] R285.5 [文献标识码] A [文章编号] 1673-7210（2018）08（a）-0004-05

[Abstract] Objective To investigate the effect of Danshen Injection on mandibular fracture of healing in rat and observe the changes of bone morphogenetic protein-2（BMP-2）， transforming growth factor-β1（TGF-β1）. Methods Forty-eight SD rats were operated for incomplete fracture of hibateral mandible penetrated from buccal side to lingual side. The rats were divided into experimental group and control group according to random number table， with 24 rats in each group. The experiment group was administered with Danshen Injection by intraperitoneal injection， and the control group was administered with physiologic saline by intraperitoneal injection. The right healing of fracture were used to detect fracture healing by X-ray and to measure the average bone density of the callus area， the percent trabecular and trabecular width were analyzed by bone histomorphometry and the serum levels of BMP-2， TGF-β1 was determined by ELISA at 1， 2， 3， 4 weeks after the operation. The right healing of fracture were comminuted， and the expression of BMP-2 and TGF-β1 were analyzed by RT-qPCR. Results The X-ray results showed that the fracture healing in the control group was obviously delayed in the experimental group. After 2 weeks， compared with the control group， the callus bone mineral density （BMD） in the experimental group was increased （P < 0.05 or P < 0.01）. The trabecular area ratio and trabecular width in the callus area were markedly increased （P < 0.05 or P < 0.01）， and the difference was even more increased along with the increasing time. ELISA results showed the serum levels of BMP-2 and TGF-β1 in the experimental group were higher than those in the control group （P < 0.05）. RT-qPCR results showed the expression of BMP-2 and TGF-β1 in the experimental group were higher than those in the control group from the 2nd week after operation （P < 0.01）. Conclusion Danshen Injection can promote the healing of mandibular fracture， which may be related to the transcription and protein expression of BMP-2 and TGF-β1 gene during the process of fracture healing.

[Key words] Danshen Injection； Mandibular fracture； Bone morphogenetic protein-2； Transforming growth factor-β1

下颌骨位于颜面下部，是颌面部体积最大且位置较为突出的骨骼。由于其解剖位置特殊，容易遭受外力而受损伤，据统计下颌骨骨折发生率占颌骨骨折的50%～70%[1]。下颌骨骨折愈合过程又较为复杂，受诸多因素的影响[2]，如饮食、年龄、损伤程度等。如何加快下颌骨骨折愈合成为口腔颌面外科医生关注的焦点。近年来，随着医学的发展，研究人员对下颌骨骨折愈合机制的认识不断拓展，中医药治疗下颌骨骨折取得了良好的效果。……