磷酸钙骨水泥载药核心的块型重组合异种骨体内缓释及修复兔长段感染性骨缺损的研究  

STUDY ON IN VIRO DRUG DELIVERY AND REPAIRING LARGE SEGMENTAL INFECTED BONY DEFECT WITH MASSIVE RECONSTITUTED BOVINE XENOGRAFT AIDED BY CALCIUM PHOSPHATE CEMENT DRUG CORE

作　　者：孙效棠[1] 赵黎[1] 胡蕴玉[1] 李丹[1] 袁志[1] 崔庚[1] 杜俊杰[1] 

机构地区：[1]第四军医大学西京医院骨二科,西安710032

出　　处：《中国修复重建外科杂志》2005年第3期165-169,共5页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：亚洲创伤骨科学会 (AADO)基金资助项目 (632 )~~

摘　　要：目的　寻找抗感染的块型重组合异种骨制备工艺简便的药物缓释方式 ,一期修复感染性长段骨缺损。方法　将载药的自凝固磷酸钙骨水泥 (calcium phosphate cement,CPC)分 4柱置入块型重组合异种骨 (massivereconstituted bone xenograft,MRBX) ,制成 CPC载药核心的块型重组合异种骨 (CPC- MRBX)。用 18只成年大白兔行体内缓释实验。按照术后 1、2、5、10、15、2 0、2 5、30和 35 d分为 9组 ,每组 2只。将 CPC- MRBX植入兔骶棘肌肌袋中 ,按各时间点测定动物的血药浓度 ,并从植骨处取软组织测定植骨区周围的药物浓度。动物模型采用兔股骨感染长段骨缺损模型 ,共 4 0只。外固定架位于膝上 1.5～ 2 .0 cm ,邻近截骨处的固定针距离截骨端 0 .5～ 0 .8cm,针道方向垂直于股骨前外侧面 ,并在植入材料后适当加压。实验组 (n=2 5 )用 CPC- MRBX修复 ,对照组 (n=15 )将自体骨段回植。术后观察动物饮食、活动和伤口的变化 ;在 4、8、16和 2 4周分别行影像学、组织学观察两组骨愈合情况。　结果　CPC- MRBX的制备过程在常温、常压下顺利完成 ,体内药物缓释实验显示组织中有效药物浓度可以维持 30 d左右 ,同时血药浓度无明显增高。动物模型的固定方法可靠 ,术后实验组动物一般情况可。术后 4 d动物能够正常站立 ,X线片示?Objective To find out an effective technique to repair large segmental infected bony defect.Methods Calcium phosphate cement(CPC) incorporated with bone morphogenetic protein and gentamycin was embedded in the massive reconstituted bovine xenograft(MRBX), then CPC MRBX was obtained after CPC's solidification. In vivo test was applied to test the drug delivery capability of CPC MRBX, in which it was implanted in the dorsal muscle pouch of 18 rabbits. The drug concentration of animal blood and surrounding soft tissue of the CPC MRBX in the muscle pouch was measured 1, 2, 5, 10, 15, 20, 25, 30 and 35 d after operation, 2 rabbits each time. Large segmental infected femur defect in the rabbit model was created to test the repairing capability of CPC MRBX. External fixation was done 1 5~2 0 cm above the knee, the most adjacent nail to fracture site was 0.5～0.8 cm away, and proper pressure was applied to the graft. In experimental group( n=25) , the bony defect was replaced by CPC MRBX, while in the control group( n =15) dissected bone block was re implanted in original position. The animal was subjected to radiographic, histological examination at 4, 8, 16 and 24 weeks. The general condition was observed after the operation. Results CPC MRBX was easily made under normal temperature and pressure. In viro drug delivery test showed that the drug concentration of the tissue remained above the minimal inhibitory concentration of staphylococcus 30 d after operation and no significant increase of blood drug concentration was observed. In experimental group, no adverse influence was observed. Four weeks after operation, the animal could bear load, bony callus around the graft was observed by X ray, and abundant chondral tissues that grew into CPC MRBX were observed by histological method. Eight weeks after operation, progressively increasing bony callus around the graft was observed, external fixation could be removed, normal function was restored, and CPC was degenerated dramatically while new bone tissu

关 键 词：磷酸钙骨水泥 重组合异种骨 药物缓释 载药核心 兔 感染性骨缺损 骨修复 

分 类 号：R687[医药卫生—骨科学]