异种骨载体复合骨形态发生蛋白修复兔甲状软骨缺损的实验  

Repair of rabbit thyroid cartilage defect with bone xenograft plus bone morphogenetic protein

作　　者：罗家胜[1] 陈文弦[1] 崔鹏程[1] 白建军[2] 刘智[1] 孙永柱[1] 

机构地区：[1]解放军第四军医大学唐都医院耳鼻咽喉科,陕西省西安市710038 [2]解放军第四军医大学唐都医院放射科,陕西省西安市710038

出　　处：《中国临床康复》2005年第18期70-71,i002,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:观察应用重组合骨修复兔甲状软骨缺损的效果,探讨其作为喉气管修复材料的可行性。方法:实验于2003-10/2004-11在第四军医大学唐都医院耳鼻咽喉科教研室实验室完成。取新西兰大白兔32只,随机分成空白对照组、单纯异种骨组、经脱脂、脱钙处理的异种骨作为载体复合骨形态生成蛋白(1∶20)的重组合骨组。制造兔甲状软骨缺损模型,于缺损处分别植入肌肉、单纯异种骨及重组合骨。分别于术后4,8,16周以及12个月观察局部及应用CT检查和造模处局部组织切片苏木精-伊红染色了解成骨和修复情况。结果:①局部观察:空白对照组缺损部位由瘢痕组织修复,在各时间点未见新骨形成。单纯异种骨组可见植入物被软组织包膜包裹,并逐渐被吸收,至16周基本完全吸收。重组合骨组可观察到植入物被吸收的同时有新骨诱导形成,16周局部有松质骨样组织形成,质地较硬,12个月后无明显变化。②组织学观察:见空白对照组无新骨形成,局部为新生瘢痕组织替代。单纯异种骨对照组可见局部有炎细胞浸润,植入物孔洞内有细胞长入,8周时植入物部分吸收,16周及12个月后缺损处异种骨基本完全吸收,为纤维组织替代修复,无明显新骨形成。重组合骨组4周可见植入处大量软骨组织诱导分化,在植入物松质骨空洞内可见组织细胞长入,周边有纤维组织包膜,以及炎细胞浸润,8周可见新骨形成,16周原植入物吸收,有大量骨基质形成并为纤维组织包绕。12个月后无明显变化。③CT检查:单纯异种骨与对照组8周左右大部分植入物被吸收,16周组织局部无骨组织显影。重组合骨组16周及12个月后局部有新骨形成,且气道形态维持良好,呼吸道通畅。结论:重组合骨具备支架的骨引导作用,其诱导成骨效果良好,是理想的喉气管修复材料。AIM:To investigate the effect of reconstituted bone xenograft(RBX) in the rep air of rabbit thyroid cartilage defect and probe into the feasibility of RBX as a material for the repair of laryngotracheal cartilage defect. METHODS:The experiment was finished in the laboratory for Department of Otorh inolaryngology,Tangdu Hospital,Fourth Military Medical University from October 2 003 to November 2004.Thirty- two New Zealand big white rabbits were divided int o blank control group,bone xenograft group and RBX group.The RBX was prepared by defatted and decalcified bone xenograft as a carrier combined with bone morphog enetic protein(1∶ 20).The models of thyroid cartilage defect were established a nd then muscle,bone xenograft and RBX were implanted into the three groups respe ctively.After 4,8,16 weeks and 12 months,the osteogenesis and the repair were an alyzed by local observation,computerized tomograthy(CT) examination and local he matoxylin and eosin(HE) staining of tissue sections in the models. RESULTS:① Local observation:The defects in the blank control group were repa ired with scar tissues,and no formation of new bone was found in each observatio n time points.In the bone xenograft group,the implants were coated with envelope s of soft tissues,then absorbed gradually and till the 16th weeks,they were comp leted absorbed.In the RBX group,the implants were absorbed accompanied by the fo rmation of new bone,and hard tissues like spongy bone formed at 16 weeks,but aft er 12 months,not any change was found.② Histological observation:No osteogenesi s was found and new scars filled locally in the defects in the blank control gro up.In the bone xenograft group,inflammatory cells grew locally in the defects,an d some cells grew into the holes of implants.The implants were absorbed complete ly at 8 weeks,and the defects were repaired with bone exnografts completely,and substituted by fibrous tissues,but new bone was not obviously found at 16 weeks and 12 months.In the RBX group,a large number of cartilage tissues

关 键 词：组织工程 骨形态发生蛋白质类 甲状软骨 

分 类 号：R318[医药卫生—生物医学工程]