引导性骨再生中成骨细胞来源的实验观察  

Experimental observation of origins of osteoblasts in guided bone regeneration in long bone

作　　者：张永刚[1] 卢世璧[1] 王继芳[1] 张伯勋[1] 解英俊[1] 

机构地区：[1]解放军总医院骨科

出　　处：《中华外科杂志》1999年第2期123-125,I006,共4页Chinese Journal of Surgery

摘　　要：目的研究长管骨引导性骨再生成骨细胞来源，进一步完善引导性骨再生理论。方法将４２只成年雄性新西兰兔在双侧桡骨中段制作标准骨缺损不愈合模型，用硅胶膜呈管状包裹一侧骨缺损，另一侧作为对照侧。１２只兔术后１～１２周分别于每周进行Ｘ线检查；３０只兔，随机分为６组，分别于术后３天、１、２、３、４、５周处死取材，分别进行常规ＨＥ染色，ＳＰ方法ＢＭＰ、ＢＧＰ抗体的免疫组化染色。结果隔膜在骨缺损局部生成隔离密闭的腔室，将周围组织阻挡于骨缺损之外，早期骨端骨内膜、骨髓基质细胞大量增殖，形成肉芽组织占据骨缺损。骨再生过程中表现出明显的组织学特征：骨痂表面为２～３层成骨细胞，骨缺损中央为肉芽组织，两者之间为数层细胞形成的移行区，细胞排列疏松，基质较多。早期骨端骨内膜、骨髓基质细胞ＢＭＰ、ＢＧＰ呈强阳性染色，骨痂生长过程中，移行区部分细胞呈阳性染色。结论引导性骨再生成骨细胞在早期来源于髓内的骨内膜和骨髓基质；骨痂形成后，成骨细胞则来源于骨内膜、骨髓、骨膜增殖细胞共同形成的肉芽组织中的间质细胞和成纤维细胞。Objective To study the origins of osteoblasts in guided bone regeneration(GBR) so as to understand the machenism of GBR. Methods New Zealand rabbits were used. Standard nonuion defect models were made in bilateral middle radial shaft of each rabbit. Randomly, one defect enveloped with sillicon membrane as test, another without membrane as control.12 rabbits were selected for X ray examination weekly after procedure.30 rabbits were divided into 6 groups, and sacrificed at 3 days,1,2,3,4,5 weeks after surgery for histological observation by immunohistochemical staining of BMP,BGP. Results The sealed spaces were made by sillicon membranes in the defects to prevent peripheral tissue ingrowing early. The defect spaces were filled by granulation tissue formed from proliferative endoperiosteal and medullary stromal cells in bone end.Histological characteristics after callus forming showed that there were 2～3 layers of osteoblasts in the surface of callus,and granulation tissue in the center of bone defect. The transforming region existed between the extending callus and ganulation tissue, which consisted of a few of cells and a lot of stroma.Early proliferative endoperiosteal and medullary stromal cells in the bone end were positive against BMP, BGP. Some cells in the transforming region were positive against BMP, BGP after callus forming. Conclusions Osteoblasts derive from endoperiosteum and medullary stroma in the early stage of GBR and from granulation tissue formed by proliferative endoperiosteal and medullary stromal cells in the later stage.

关 键 词：骨再生 成骨细胞 骨钙素 骨缺损 

分 类 号：R681[医药卫生—骨科学]