利福平-珊瑚羟磷灰石复合物预防骨感染的实验研究  

Experimental Study in the Prophylaxis of Osseous Infection with RFP-Coralline Hydroxyapatite Porites Composites

作　　者：邹学农 孙材江[1,2,3,4] 廖龙元 孟志斌[1,2,3,4] 钱金黔 

机构地区：[1]珠海市医疗中心骨科 [2]湖南医科大学附二院骨科 [3]海南医学院附院骨科 [4]中国人民解放军117医院骨科

出　　处：《中华骨科杂志》1998年第10期610-614,共5页Chinese Journal of Orthopaedics

摘　　要：目的：本研究旨在探讨珊瑚羟磷灰石（ｃｏｒａｌｉｎｅｈｙｄｒｏｘｙａｐａｔｉｔｅｐｏｒｉｔｅｓ，ＣＨＡＰ）作为抗生素载体及释放系统的特征以及局部释放抗生素防治骨感染的作用。方法：将ＣＨＡＰ作为抗生素的载体，以利福平（ｒｅ－ｆａｍｐｉｃｉｎ，Ｒ）为模型药物，制备成吸附抗生素的ＣＨＡＰ复合物（Ｒ－ＣＨＡＰ），进行体内、外药物释放试验。采用高效液相色谱法测定标本的ＲＦＰ浓度。将Ｒ－ＣＨＡＰ、空白ＣＨＡＰ分别植入污染不同毒力金葡菌的兔骨缺损区，经放射学检查，细菌培养及组织病理学检查判断骨感染的发生情况。结果：体内、外药物释放试验显示，Ｒ－ＣＨＡＰ在４周内持续释放高浓度的抗生素，血清浓度明显低于局部浓度；组织炎性反应小，生物相容性好。Ｒ－ＣＨＡＰ植入污染不同毒力金葡菌的骨缺损区，其抗菌作用效果无差异（Ｐ＞０．０５），较植入空白ＣＨＡＰ对照组的骨感染发病率低（Ｐ＜０．０５）；两者对金葡菌无特异性的亲和力。结论：ＣＨＡＰ是一种较为理想的抗生素载体及释放系统，局部应用Ｒ－ＣＨＡＰ可有效地预防骨缺损深部感染的发生。Objective:To solve the problem of diffusion of drugs using a coralline hydroxyapatite porites (CHAP) as a skeletal antibiotics carrier to skeletal tissue at high local concentrations for a desirable therapeutic effects of osseous infections.Materials and Methods:Rifampin was used as a model drug,and prepared as a composite of CHAP with Rifampin (R-CHAP) for use as a nantibiotic delivery system with sustained effect.In vitro and in vivo drug delivery analyses of R-CHAP were performed.The RFP concentration of experimental sample was determined by HPLC assay.The composites were implanted in the open defects of proximal part of the rabbit tibia contaminated with various virulent strains of S.Aureus.The incidence of osseous infection was evaluated.Results:In vitro and in vivo evaluation of R-CHAP,revealed a high concentration level of antibiotics which sustained for at least four weeks.The RFP concentrations in serum were lower than in local bone tissue.Local tissue inflammatory reaction was very slight and the R-CHAP was well to lerated by the body of animal after implantation of the laboratory material.The incidence of osseous infection with a weak virulent strain was not significant while it is different from that of a strong virulent strain ( P >0.05).This frequency was significantly lower ( P <0.05)when compared with controlled groups implanted plain CHAP.Both of the R-CHAP may not be prone to idiosyncratic affinity of S.Aureus.Conclusions:These findings suggest that the CHAP be an ideal carrier and delivery system for antibiotics,the R-CHAP can be effectively applied in the prophylaxis of deep wound infection of bone defect.It might be widely used in various clinical situations,and further study should be engaged.

关 键 词：骨感染 预防 利福平 珊瑚羟磷灰石 

分 类 号：R681.201[医药卫生—骨科学]