Histomorfometrijska analiza regeneracije kosti kod kunića sa dijabetesom melitusom posle primene autotransplantata kosti i beta-trikalcijum fosfata
Sažetak
Uvod/Cilj. Mehanizam otežanog zarastanja tkiva kod dijabetesa melitusa zasnovan je na različitim promenama funkcije na tkivnom i ćelijskom nivou, usled prisutnih mikro- i makrovaskularnih promena. Kao hronično metaboličko oboljenje sa vaskularnim komplikacijama, dijabetes melitus zahvata i proces koštane regeneracije. Terapijski postupci u okviru regeneracije kosti obuhvataju primenu autotransplantata sa oseoinduktivnim delovanjem i sintetskih osteokonduktivnih materijala, kao što je i β-trikalcijum fosfat. Cilj ovog rada bio je da se ispita kvantitet i kvalitet novoformiranog koštanog tkiva posle korišćenja autotransplantata kosti i β-trikalcijum fosfata, na modelu kritičnog defekta kalvarije kunića sa eksperimentalno izazvanim dijabetesom melitusom tipa I. Metode. U ovo istraživanje bilo je uključeno 8 kunića (soj Činičila), starosti 4 meseca, kod kojih je dijabetes melitus tipa I bio izazvan aloksanom. Kod svih životinja hirurški je urađen defekt kritične veličine na kosti kalvarije (prečnika 12 mm), koji je popunjen autotransplantatom kosti i β-trikalcijum fosfatom (n = 4) ili je ostavljen da spontano zarasta kao kontrolni defekt (n = 4). Posle 4 nedelje, sve životinje su bile žrtvovane i koštani uzorci uzeti za histološku i histomorfometrijsku analizu. Pored deskriptivne histološke analize, urađena je i kvantitativna analiza novoformirane kosti, vezivnog tkiva i materijala za koštanu regeneraciju. Statistička analiza vršena je primenom Friedman-ovog testa i post hock Vilkoksonovog neparametrijskog testa sa stepenom značajnosti od p < 0,05. Rezultati. Histološka analiza uzoraka kosti pokazala je prisustvo novoformirane kosti na periferiji defekta, dok je u centralom delu bilo prisutno vezivno tkivo, nezrelo koštano tkivo i dobro sjedinjeni neresorbovani materijal za regeneraciju kosti. Kontrolni uzorci nisu pokazali koštano zarastanje defekata. Značajno više novoformirane kosti bilo je prisutno u defektima regenerisanim autotransplantatom (53%) u poređenju sa kontrolnim defektima (7%), (p < 0,000) i defektima popunjenim β-trikalcijum fosfatom (30%), (p < 0,030). Takođe, značajna razlika uočena je i između grupe sa β-trikalcijum fosfatom i kontrolnim koštanim defektom (p < 0,008). Zaključak. Primena autotransplantata kosti značajno povećava uspešnost regeneracije kritičnih defekata kosti kalvarije kunića sa dijabetesom melitusom tipa I.
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