自体软骨细胞移植修复猪膝关节软骨缺损的实验研究  

Experiment study on the repair of pig articular cartilage treated with autologous chondrocyte implantation

作　　者：周新社[1] 戴尅戎[1] 汤亭亭[1] 严孟宁[1] 贾庆卫[1] 

机构地区：[1]上海交通大学附属第九人民医院骨科,200011

出　　处：《中华骨科杂志》2007年第6期455-459,共5页Chinese Journal of Orthopaedics

摘　　要：目的评价传统和复层高密度培养（复层培养）的自体软骨细胞移植修复关节软骨缺损的效果。方法在8头猪16膝髌切迹上下共建立32个全层软骨缺损，右膝为空白和自体骨膜移植对照组，左膝为传统的自体骨膜覆盖下细胞注射移植组和自体骨膜覆盖下复层培养细胞移植组（上下缺损随机进入各对照和实验组）。术后5-6个月对缺损部位行大体、组织学、免疫组织化学检查。采用O’Driscoll软骨组织形态学评分评价软骨缺损的修复质量。结果四组的O’Driscoll软骨组织形态学评分分别为（3．14±1．95）分、（10．57±3．60）分、（16．29±2．63）分、（20．43±1．81）分，各组之间差异均有统计学意义（P〈0．01）。空白对照组缺损被少量的纤维组织覆盖；骨膜移植组被纤维组织和少量的纤维软骨修复，且与周围组织整合差。自体软骨细胞移植（注射组和复层培养组）缺损被塑形良好的修复组织覆盖，组织学、基质特殊染色示修复组织为纤维软骨和透明软骨，与周边软骨和软骨下骨整合良好。复层培养组修复组织的细胞形态、基质染色比注射细胞组更接近正常软骨。结论自体软骨细胞移植可成功修复全层关节软骨缺损。扩增后的软骨细胞经短期复层培养更有利于软骨缺损的修复。Objective To compare and evaluate the repair effect of the articular cartilage defect with traditional and polylayer cultured autologous chondrocyte implantation （ACI）. Methods 32 full-layer cartilage defects at trochlear in eight pigs （16 knees） were established. The right knees served as untreated group and periosteum treated group, the left knees as ACI treated groups （including traditional monolayer cultured autologous chondrocyte injection group and polylayer cultured autologous chondrocyte covered group）. Each defects entered randomly into control group or treated groups. The regenerative tissue was assessed macroscopically, microscopically, matrix specific and histological-histochemical stain and semi-quantity cartilage scoring employing O＇Driscoll repaired cartilage value system from 5 to 6 months postoperatively. Results 5-6 months postoperatively, the O＇Driscoll cartilage scoring were 3.14±1.95, 10.57±3.60, 16.29±2.63, 20.43±1.81 in the control, periosteum treated, traditional monolayer ACI treated and polyplayer culture groups respectively, difference between them were significant（P〈 0.01）. Defects in untreated group were covered with little fibrous tissue and in periosteum treated group covered with fibrous tissue and little fibrocartilage which badly integrated with adjacent normal cartilage and subchondral bone. Defects in ACI treated group （including monolayer and polylayer culture group） were covered with goodly contoured tissue, which were fibrocartilage and hyaline cartilage, also integrated completely with adjacent normal cartilage and subchondral bone; however, the cells morphology and matrix stain in repair tissue were more like to hyaline cartilage in polylayer culture group than in monolayer culture group. Conclusion ACI can successful repair full thickness cartilage defect; but chondrocytes muhiplicated and polylayer cultured be more beneficial to cartilage repair.

关 键 词：膝关节 软骨细胞 移植 自体 

分 类 号：R686[医药卫生—骨科学]