磷酸钙骨水泥修复羊实验性胫骨平台压缩性骨折的组织学研究  

Histology study of calcium phosphate cement in repairing goat experimental lateral tibial plateau compression fracture

作　　者：苗军[1] 夏群[1] 刘春蓉[2] 张继东[1] 白剑强[1] 黄洪超[1] 徐宝山[1] 

机构地区：[1]天津市天津医院脊柱外科,300211 [2]天津武警医学院病理教研室

出　　处：《中华骨科杂志》2008年第10期838-843,共6页Chinese Journal of Orthopaedics

基　　金：国家自然科学基金资助课题（30500516）

摘　　要：目的观察磷酸钙骨水泥在修复羊实验性外侧胫骨平台压缩性骨折中的吸收与成骨特点。方法成年健康山羊10只，于双下肢外侧胫骨平台制作压缩性骨折伴骨缺损模型。一侧下肢缺损用磷酸钙骨水泥填充，对侧用自体骨填充。术后3个月和6个月分别处死5只动物，取双侧胫骨近端组织块，进行电镜观察；制备不脱钙切片进行组织学观察骨水泥吸收、自体骨吸收及新骨形成情况；测量骨形态计量学参数。结果骨水泥表面可见大量重建陷窝锥形切割指向并穿入骨水泥，表面被无数破骨细胞和成骨细胞覆盖，骨水泥与表面的新生红色骨小梁结合紧密，无任何软组织层介入。骨形态计量学静态参数显示，骨水泥面积在3个月时为43．8％，6个月时仅剩29．9％；成骨细胞指数和破骨细胞指数在3个月时最大，至6个月时减小。动态参数显示，骨水泥组双标记线间的平均距离和矿化沉积速率与自体骨组接近，差异无统计学意义。结论磷酸钙骨水泥在羊体内具有良好的降解成骨性能，骨水泥降解吸收高峰在3个月，植入6个月内骨水泥的吸收速度与骨形成速度基本持平，可作为合适的自体骨替代材料填充骨缺损。Objective To observe the degradation and bone formation characteristics of calcium phosphate cement used in goat experimental lateral tibia] plateau compression fracture. Methods Bilateral tibial plateau compression fractures with bone defect model were made in ten goats. The fractures were re- duced and fixed with calcium phosphate cement or autograft. Specimens of tibial plateau were retrieved 3 months and 6 months after operation. Nondeealeified section were made. Degradation of calcium phosphate cement and new bone formation were evaluated by electron microscope and light microscope. Bone histomor- phometry including static and dynamic parameters were measured. Results There were many remolding la- cune like cone cutting into bone cement. Numerous osteoblast and osteoclast covered the surface of bone ce- ment. Bone cement connected new bone tightly without any fibrous tissue intervening. Static parameters showed the bone cement area decreased to 43.8% at 3rd month and 29.9% at 6th month. Osteoblast index and osteoclast index increased maximum at 3rd month indicated that the activity of bone cement resorption and bone formation reached peak at 3rd month. Dynamic parameters showed that distance of double lable and mineral appositional rate in bone cement group were similar with autobone graft group, which indicated that the speed of cement resorption was equal to new bone formation. Conclusion Calcium phosphate ce- ment have excellent ability of resorption and new bone formation in big animal. The resorption speed is cor- responding to the new bone formation. Calcium phosphate cement is one of the best bone substitute used for plateau compression fracture.

关 键 词：磷酸钙类 胫骨平台骨折 山羊 组织学 

分 类 号：R686[医药卫生—骨科学]