自体骨髓基质干细胞在齿槽裂骨缺损修复中的应用  

Repair alveolar cleft bone defects with bone marrow stromal cells

作　　者：柴岗[1] 张艳[1] 胡晓洁[1] 王敏[1] 刘伟[1] 崔磊[1] 曹谊林[1] 

机构地区：[1]上海第二医科大学附属第九人民医院整形外科,上海市组织工程研究重点实验室

出　　处：《中华整形外科杂志》2006年第6期409-411,共3页Chinese Journal of Plastic Surgery

基　　金：国家高科技研究发展规划资助项目863(2002AA205011);上海交大二医合作基金;上海第二医科大学博士点课题

摘　　要：目的探讨人自体骨髓基质干细胞（human bone marrow stromal cells，hBMSCs）在治疗齿槽裂骨缺损中的可行性。方法2002至2005年，选择齿槽裂骨缺损患者7例（单侧6例，双侧1例），以患者自体骨髓基质干细胞为种子细胞，部分脱钙骨（partly demineralized bone matrix，pDBM）为支架材料构建组织工程骨，治疗齿槽裂骨缺损。从患者髂前上棘穿刺取骨髓，密度梯度离心法分离hBMSCs，经体外成骨诱导和扩增至第3代。将诱导的hBMSCs，复合部分脱钙骨体外培养1周后，手术回植骨缺损区。分别于术后1、3、6、12、24、36个月进行临床外形和三维CT检查随访。结果6例患者头部三维CT检查，结果示术后3个月能形成组织工程化骨，并修复骨组织缺损。术后1～3年的随访表明组织工程骨稳定存在，无明显骨吸收现象，临床治疗效果稳定。1例患者（双侧齿槽裂）植入物外露感染。结论以自体hBMSCs为种子细胞，部分脱钙骨为支架材料，利用组织工程技术可在人体内形成稳定的组织工程化骨组织，并临床修复齿槽裂骨缺损。Objective To explore the feasibility of repairing alveolar cleft bone defects with bone marrow stromal cells. Methods Total 7 patients of alveolar cleft were included in this study. The hBMSCs were isolated by pereoll gradient centrifugation from patient＇s bone marrow aspirated from iliac crest. The hBMSCs were cultured in vitro and induced to become osteogenic cells in the DMEM medium containing 10% self-serum, beta-glycerophosphate（10 nmol/L） dexamethasone （10^-8 mol/L）, L-2-ascorbic acid（50 μmol/L）, and 1, 25 （OH）2VD3 （10 nmol/L）. Induced hBMSCs of passage 3 were harvested and seeded onto partly demineralized allogenic bone matrix （pDBM） to form a cell-scaffold construct and in vitro co-culture for 1 week. The defects were repaired with the cell-scaffold construct. All cases were followed up for 3, 6 months post-operation as short- term evaluation and l to 3 years post-operation as long-term evaluation by three-dimensional computerized tomography （3D-CT） and clinical examination. Results 3D-CT demonstrated that engineered bone was formed in 3 months post-operation. Additionally, formed bone maintained stable up to 1 -3 years without absorption. Conclusions Engineered bone can be used to repair clinical alveolar cleft bone defects.

关 键 词：骨髓基质干细胞 骨缺损 组织工程 齿槽裂 

分 类 号：R782.2[医药卫生—口腔医学]