负载重组人骨形态发生蛋白-2的超高相对分子质量聚-DL-乳酸接骨板修复骨折的研究  

A bioabsorbable super-high molecular weight poly D, L-Lactic acid plate containing recombinant human bone morphogenetic protein-2 for fracture healing

作　　者：王金武[1] 郭尚春[1] 孙贵新[1] 谭瑞珍[3] 赵炳辉[2] 范存义[1] 倪伟峰[1] 曾炳芳[1] 李雪松 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233 [2]上海交通大学附属第六人民医放射科,200233 [3]复旦大学医学院人体解剖与组织胚胎学系 [4]成都迪康中科生物医学材料有限公司

出　　处：《中华创伤骨科杂志》2007年第8期703-707,共5页Chinese Journal of Orthopaedic Trauma

基　　金：上海市卫生局青年科研基金（034y14）;上海市博士后科研基金（o1-1）

摘　　要：目的利用可吸收超高相对分子质量聚-DL-乳酸（PDLLA）接骨板作为缓释重组人骨形态发生蛋白-2（rhBMP-2）的载体，通过体内活性实验来评估其固定骨折及修复缺损的效果。方法新西兰大白兔32只，制成双侧尺骨中段2．5mm骨及骨膜缺损模型，右侧为实验组，左侧为对照组，实验组采用复合rhBMP-2的PDLLA接骨板固定，对照组采用普通PDLLA接骨板固定。随机分为四组，每组8只，分别于术后2、4、8、12周行大体观察、X线片、组织病理切片观察及计算机图像分析观察，比较两种不同方法在不同时段对骨折与缺损的修复情况，以及固定效果与体内降解情况。结果术后2、4、8、12周行大体观察及X线片检查示两种生物活性接骨板均固定牢固，骨折端无移位，对位、对线良好。结合组织病理切片观察，术后8周，7只动物实验侧骨折及缺损区获得骨折修复，2只动物对照侧存在较少量骨痂相连，其余动物骨缺损主要由纤维结缔组织填充；术后12周，8只动物两种不同方法固定的骨折及缺损区均获得修复，但实验组固定板材与周围组织的相容性、成骨速度、骨再生量、再生髓腔结构等方面均优于对照组，计算机图像分析结果显示同时期内实验组骨小梁的生成数量和质量均显著优于对照组（P〈0．01）。结论复合rhBMP-2的可吸收PDLLA接骨板生物相容性好，对X线等成像检查无干扰，并具有良好骨诱导性和骨缺损修复能力，无需二次手术取出。Objective To investigate the effect of a bioabsorbable super-high molecular weight poly D, L-Lactic acid （PDLLA） plate containing sustainingly released recombinant human bone morphogenetic protein-2 （rhBMP-2） on fracture internal fixation and healing in an activity experiment in vivo. Methods Thirty-two New Zealand rabbits （male or female） were used in the study. Osteotomy of a 2.5 mm middle ulna was conducted bilaterally. The right experimental side was fixated internally with PDLLA containing rhBMP-2, while the left control side fixated with common PDLLA. All rabbits were randomly divided into 4 groups. After follow-up of 2, 4, 8 and 12 weeks, the ulnas were examined visually, radiographically, histologically, and by computer graph analysis to compare the fracture healing, fixation results and degradation process at different times after being fixated by the two types of plates. Results Visual observations and radiograph examinations 2, 4, 8 and 12 weeks postoperatively demonstrated that ulnar fractures were fixated stably by the two bioactive plates. No dis- placement was observed, and good reduction was maintained. Histological examination showed that 8 weeks after operation 7 rabbits had a good healing on the experiment side, 2 rabbits had a little callus on the control side, and the other rabbits only had fibro-connective tissue filled in the defects. Twelve weeks postoperatively, 8 rabbits had a good healing on both sides, but the experiment side showed better compatibility between plate and surrounding tissue, faster bone formation, more bone regeneration mass and better medullary canal structure. Computer graph analysis indicated that at the same period better and more trabeculae formed on the experiment side （ P 〈 0. 01 ） . Conclusion The bioabsorbable super-high molecular weight PDLLA plate containing rhBMP-2 has good biocompatibility and osteoinducive activity to enhance fracture healing, does not interfere with radiographical examination, and does not necessitate removal of the impl

关 键 词：骨形态发生蛋白质类 乳酸 骨折愈合 骨折固定术 内 药物载体 

分 类 号：R686[医药卫生—骨科学]