骨形成蛋白与磷酸钙复合材料对椎体骨缺损的修复作用  

Reconstruction of vertebral bone defects with composite material of cement calcium phosphate and bone morphogenetic protein

作　　者：王瑞[1] 靳安民[2] 宋富立[2] 

机构地区：[1]北京朝阳医院京西院区骨科,北京100043 [2]南方医科大学珠江医院骨科,广州510282

出　　处：《武警医学》2008年第5期401-403,F0003,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的 探讨骨形成蛋白（BMP）与磷酸钙骨水泥（CPC）复合材料在椎体骨缺损的修复能力及其作为椎体成形术的生物活性灌注剂可能性。方法 将CPC作为BMP的载体复合成为CPC／BMP生物活性人工骨材料。在16只羊腰1～3椎体侧前方制成约1cm×1cm×1cm的骨缺损，分别植入CPC／MBP生物活性人工骨材料和CPC。术后3、6个月行X线、组织学检查和电镜扫描。观察新骨形成和材料降解情况。结果 术后所有的动物成活。CPC／BMP植入3个月时植入材料与受区骨间出现软骨细胞向成骨分化，新骨组织长入材料并与材料紧密结合。6个月时新骨多为板层骨，植入材料范围缩小，材料大量溶解，出现较大的空隙。BMP与CPC复合有效地促进了新骨的形成和新骨的钙化，同时也加速CPC材料的降解。而CPC材料降解速度缓慢，新骨形成量少，仅在材料的表面。结论 CPC是BMP理想的载体，CPC／BMP生物活性人工骨材料椎体骨缺损有较强的修复能力，可作为椎体成形术的生物活性灌注剂。Objective To study the reconstruction of vertebral bone defects by using composite material of cement calcium phosphate （CPC） and bone morphogenetic protein （BMP）,compared with CPC/BMP.Methods Bone defects of 1 cm× 1 cm×1 cm in 16 goats were made in L1, L2 and L3 vertebral bodies through anterolateral lumbar approach. CPC/BMP and CPC were implanted into the bone defects separately. The specimens were harvested at the end of 3 and 6 months after operation. The new bone formation and the biological degradation of material were evaluated by X-rays, histological examination, and scanning electron microscopy （SEM）. Results All the animals survived after operation, and no toxic reactions were found. New bone formation increased significantly in CPC/BMP group with the time of implantation. Histomorphologically, chondrocytes and woven bone were found at 3 months in CPC/BMP group. Remodeling of new lamellar bone and absorption of the composite material were observed at 3 months;the material was combined with new bone.After 6 months a great deal of lamellar bone was found in CPC/BMP group, the material was dissolved, and big micropores appeared. The defect was nearly repaired. During the repairing process of bone defect, the material degraded while new bone formed; the speed of degradation in CPC/BMP was evidently higher than that in the CPC group. Conclusions The CPC/BMP composite has great potentiality in repairing vertebral bone defects and can be used as a bioactive filling material in vertebroplasty.

关 键 词：骨形成蛋白 羟基磷灰石 骨缺损 骨重建 

分 类 号：R318.08[医药卫生—生物医学工程]