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[关于制动所致骨质疏松的组织形态计量学和生物学数据]

[Histomorphometric and biological data on osteoporosis due to immobilization].

作者信息

Minaire P, Meunier P, Edouard C, Bernard J, Courpron P

出版信息

Rev Rhum Mal Osteoartic. 1975 Jul-Sep;42(7-9):479-88.

PMID:1179130
Abstract

The effect on the bones of immobilization was studied by means of quantitative histological methods on 34 biopsies of the iliac crest after different periods of immobilization in 28 patients, 22 of whom were immobilized by medullary lesions. At the same time a biochemical study was carried out on 68 immobilized patients over a 52-week period. This histomorphometric study included measurements of the absolute volume of trabecular bone, the volume of the osteoid matrix, the osteoclastic resorption surfaces, the size of the osteocyte lacunae, the thickness of the iliac cortical zones and the medullary adipose volume. 19 subjects received in addition double labeling with tetracycline with the object of carrying out a histodynamic study of the osteoblastic activity. The decrease in the absolute volume of the trabecular bone reached 33 percent of its original value and continued up to the 25th week, and was followed by stabilization at a value slightly higher than the vertebral fracture limit. Immobilization also led to an increase in the osteoclastic resorption surfaces and, secondarily, to an increase in the periosteocyte lacunae, a thinning of the iliac cortical zones, and a decrease in the volume of the osteoid matrix. Calciura increased as did total hydroxyprolinuria in parallel with an increase in the resorption surfaces. The histological and biochemical changes suggest a histodynamic hypothesis, according to which the longevity of the basic multicellular bone unit increases, leading to a new equilibrium characterized by very slow renewal of the bone.

摘要

通过定量组织学方法,对28例患者在不同固定期后的34份髂嵴活检标本进行研究,以探讨固定对骨骼的影响。其中22例因骨髓病变而固定。同时,对68例固定患者进行了为期52周的生化研究。这项组织形态计量学研究包括测量小梁骨的绝对体积、类骨质基质的体积、破骨细胞吸收表面、骨细胞陷窝的大小、髂骨皮质区的厚度和骨髓脂肪体积。19名受试者还接受了四环素双重标记,以便对成骨细胞活性进行组织动力学研究。小梁骨绝对体积的减少达到其原始值的33%,并持续到第25周,随后稳定在略高于椎体骨折极限的值。固定还导致破骨细胞吸收表面增加,其次导致骨细胞陷窝增加、髂骨皮质区变薄和类骨质基质体积减少。尿钙增加,总羟脯氨酸尿也增加,与吸收表面的增加平行。组织学和生化变化提示了一种组织动力学假说,根据该假说,基本多细胞骨单位的寿命增加,导致以骨更新非常缓慢为特征的新平衡。

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