优化配方的CPC/DBM/rhBMP-2复合材料修复兔大段长骨缺损的长期观察  

Healing of critical size segmental long bone defects by CPC/DBM/rhBMP-2 composites with optimal formula in rabbits:a long-term observation

作　　者：任民[1] 任玉 甄平[1] 周勇[3] 杨彤涛[3] 范清宇[3] 

机构地区：[1]兰州军区兰州总医院骨三科,兰州730050 [2]武威市中心血站,甘肃武威733000 [3]第四军医大学唐都医院全军骨肿瘤研究所,西安710038

出　　处：《解放军医学杂志》2010年第10期1196-1198,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察磷酸钙骨水泥(CPC)/脱钙骨基质颗粒(DBM)/重组人骨形成蛋白-2(rhBMP-2)复合材料植入修复大段骨缺损的长期X线变化和组织学特征。方法预制兔DBM,将其与rhBMP-2充分混匀,真空下形成DBM/rhBMP-2复合物,后者与CPC按质量比2∶8(DBM∶CPC)的比例制作CPC/DBM/rhBMP-2复合材料,其中含rhBMP-2的量约1.2mg/cm3。取健康成年新西兰兔36只,随机分为A、B、C三组,每组12只。制作15mm桡骨缺损模型,A组旷置骨缺损,B组植入CPC,C组植入复合材料。于术后6、12、24、36周追踪X线摄片,第36周全部处死行组织学观察。结果 X线摄片显示:A组术后各期骨缺损均未修复,最终骨断端萎缩。B组术后各期骨痂均稀少,CPC材料外形、密度无明显变化。C组术后6周复合材料周围形成少量骨痂,材料-骨界面模糊,材料边缘不规则、密度减低、体积缩小;第12周骨痂生长丰富,材料-骨界面消失,材料失去原有外形,轮廓变小;第24周骨痂连续通过骨缺损,桡骨一侧已形成连续的骨质,材料大部分被吸收,髓腔部分再通;术后36周桡骨缺损区两侧均形成连续的骨皮质,且髓腔完全再通,外形恢复满意。术后第36周组织学观察见A组骨缺损为瘢痕样软组织所填充;B组骨缺损部位仍为CPC填充,材料内部未见新骨和纤维组织出现;C组骨缺损已修复,材料残留少部分未被吸收,大部分被新骨替代。结论优化配方的复合材料能够较好地修复兔大段桡骨缺损。Objective To observe the radiographic changes and histological features in critical size segmental long bone defects after implantation of composites consisted of decalcified bone matrix （DBM） impregnated calcium phosphate cement （CPC） with recombinant human bone morphogenetic protein 2 （rhBMP-2）. Methods To prefabricate the rabbit DBM, mix it up with rhBMP-2, form the composites of DBM/rhBMP-2 under vacuum, then the composites of CPC/DBM/rhBMP-2 were made at a mass ratio of 2：8 of DBM： CPC, and the content of rhBMP-2 is about 1.2mg/cm3. Thirty-six healthy adult New Zealand rabbits were undergone osteotomy to reproduce 1.5mm radial defect model and then divided into groups A, B and C （12 each）. The bone defects of group B and C were implanted with CPC and CPC/DBM/rhBMP-2 composites respectively, while the bone defects of group A remained untreated. Animals were examined by radiography continuously in the 6th, 12th, 24th and 36th week after operation. All rabbits were sacrificed in the 36th week and the implants were examined histologically. Results X-ray examination showed that the radial defects in group A were not restored at anytime after operation and the broken margin finally shrank. In group B, a few callus were seen around the implants in radial defects, and no obvious change was found of the appearance and density of CPC during 6-36 weeks after operation. In group C, some callus formed 6 weeks after operation around the composites in radial defects, the interface of implants and bone tissue was fuzzy, the margin of implants became irregular, decreased in density and shrunken in size; 12 weeks after operation, plenty of callus were observed around the implants, the interface of implants and bone tissue disappeared, the implants became hazy in their intrinsic appearance and shrunken in size; 24 weeks after operation, the callus in radial defects were successively connected, successive bones formed unilateral radial, most of the implants were absorbed, and medullary cavity became partly r

关 键 词：磷酸钙骨粘合剂 骨基质 脱钙 骨形态发生蛋白质类 骨缺损 骨代用品 

分 类 号：R318.08[医药卫生—生物医学工程]