复合富血小板血浆的酶处理异种骨修复兔桡骨缺损  

Combined use of xenograft bone after enzyme processing and platelet-rich plasma to repair rabbit radius bone defects

作　　者：黄若昆[1] 林月秋[1] 滕寿发[1] 胡益华[1] 郑永智[1] 

机构地区：[1]解放军成都军区昆明总医院附属骨科医院,全军骨科中心,云南省昆明市650032

出　　处：《中国组织工程研究与临床康复》2007年第49期9898-9901,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:自源性的富血小板血浆可促进骨组织及软组织的修复,又不存在疾病传播及免疫排斥的可能。实验拟验证应用复合富血小板血浆的酶处理异种骨修复节段性骨缺损的可行性。方法:实验于2006-07/12在解放军昆明总医院实验动物中心完成。①实验分组:选用新西兰大耳白兔20只,体质量2.0～2.5kg,共40只前肢,随机分为复合酶组,单纯酶组,脱蛋白骨组,空白组。每组共10个标本。②实验方法:制作富血小板血浆及酶处理的异种骨并制备桡骨中段15mm的节段性骨缺损模型,将上述骨材料植入兔桡骨缺损处,其中复合酶组:植入复合富血小板血浆的酶处理异种骨;单纯酶组:植入酶处理异种骨;脱蛋白骨组:植入部分脱蛋白骨;空白组:不植入任何材料。③实验评估:分别于术后4,8,12周取材,X线片及苏木精-伊红染色分别观察骨缺损区的新骨形成情况。同时对各组骨密度进行测定。结果:纳入新西兰大耳白兔20只,均进入结果分析,所有手术无术后感染,无动物死亡,植入骨无脱落。①所有动物麻醉苏醒后均恢复进食,2周伤口愈合,未出现感染及渗液等。富血小板血浆中的血小板含量均为全血的4倍以上。②在同一时间点,酶处理后异种骨与部分脱蛋白骨在成骨能力方面差异无显著性意义,而复合富血小板血浆的酶处理异种骨在8周时骨缺损部分修复;12周时完全修复。空白组骨缺损未修复。③8,12周时复合酶组骨密度较单纯酶组、脱蛋白骨组高,差异有显著性意义(P<0.05);单纯酶组与脱蛋白骨组比较无明显差异(P>0.05)。结论:经酶处理后异种骨可用于节段性骨缺损的修复,复合富血小板血浆后有明显加速骨愈合的作用。AIM： Platelet-rich plasma （PRP） can accelerate the repairs of bone defect and soft tissue, excluding the possibility of disease propagation and immunological rejection. This study was designed to observe the effects of combined use of heterogeneous bone after enzyme processing and PRP on repairing of segmental bone defects. METHODS： The experiment was conducted in the Experimental Animal Center of Kunming General Hospital of Chinese PLA from July to December in 2006.（1）Twenty New Zealand big-ear white rabbits （40 anterior limbs）, aged 2.0-2.5 kg, were randomly divided into four groups with five rabbits in each group： complex PRP enzyme processing group, enzyme processing group, deproteinization group and blank control group. （2）A 15-mm radius segmental defect of rabbits was implanted with complex PRP enzyme processing bones, enzyme processing bones and partially deproteinized bones, respectively. The blank control group received no material （3）The specimens were examined 4, 8, 12 weeks postoperatively; the osteogenesis on bone defect area was evaluated through X-ray radiograph, hematoxylin-eosin stain and bone density examination. RESULTS. All the 20 New Zealand big-ear white rabbits were involved in the result analysis. No infection, death or implanted bone shedding appeared. （1）All animals survived after the anesthesia. The wound healed two weeks postoperatively without infection or effusion. The number of platelet in PRP was four times more than that of whole blood. （2）There was no statistical difference in the osteogenesis between the enzyme processing group and partially deproteinization group during the same period. There were partial repairs of bone defect at week 8 and full repairs at week 12 in the complex PRP enzyme processing group. While no bone defect was repaired in the blank group. （3）Bone mineral density at weeks 8 and 12： It was significantly higher in the complex PRP enzyme processing group than in the enzyme processing group and partially deproteinization

关 键 词：骨移植 移植 异种 酶 富血小板血浆 

分 类 号：R667.34[医药卫生—外科学]