EVIDENCE FOR A HUMORAL MECHANISM FOR ENHANCED OSTEOGENESIS AFTER HEAD-INJURY
EVIDENCE FOR A HUMORAL MECHANISM FOR ENHANCED OSTEOGENESIS AFTER HEAD-INJURY
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DOI：
10.2106/00004623-199072080-00004
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发表时间：
1990-09-01
影响因子：
5.3
通讯作者：
GOLTZMAN, D
中科院分区：
文献类型：
--
作者：
BIDNER, SM;RUBINS, IM;GOLTZMAN, D
在颅脑损伤合并骨折的患者中，骨折愈合速度加快，大量骨痂形成。这背后的机制尚不清楚。我们研究了循环生长因子增加或刺激局部释放生长因子的循环因子介导成骨增加的可能性。血清样本来自32名受试者：仅有颅脑损伤的患者，有颅脑损伤和下肢骨折的患者，只有骨折的患者，以及既没有头部损伤也没有骨折的对照受试者。重型颅脑损伤定义为昏迷持续至少3天。通过测定血清对胎鼠颅骨成骨细胞原代培养中[~3H]胸腺嘧啶核苷掺入和细胞计数的影响来测定生长因子活性。这两组头部损伤患者的血清样本比其他两组样本有更高的有丝分裂活性和细胞数量的增加。在前两组之间或仅有骨折的患者与对照组之间，平均活动水平没有统计学上的差异。稀释法研究表明，颅脑损伤患者血清中丝裂原活性的增加是剂量依赖性的。在对其进行研究的三名患者中，有丝分裂活性在头部损伤持续约37天后达到顶峰。
The rate of fracture-healing is accelerated and abundant callus develops in patients who have a head injury and fractures. The mechanism underlying this is unclear. We studied the possibility that increased circulating growth factors or circulating factors that stimulate local release of growth factors mediate the increased osteogenesis. Samples of serum were obtained from thirty-two subjects: patients who had a head injury alone, those who had a head injury and fractures of the lower extremities, those who had only fractures, and control subjects who had neither a head injury nor a fracture. Severe head injury was defined as that producing coma of at least three days'' duration. Growth-factor activity was determined by assessing the effect of serum on the incorporation of [3H]thymidine and on cell counts in primary cultures of osteoblastic cells from the calvaria of fetal rats. Samples of serum from the two groups of patients who had a head injury had higher mitogenic activity and produced a greater increase in the number of cells than did the samples from the other two groups. The mean levels of activity were not statistically different between the first two groups or between the patients who had fractures only and the control subjects. Dilution studies showed that increased mitogenic activity in the serum from the patients who had a head injury was dose-dependent. In three patients in whom it was studied, the mitogenic activity peaked approximately thirty-seven days after the head injury was sustained.