复合骨形态发生蛋白-2的人工骨结合带血供组织修复羊桡骨大段骨缺损的实验研究  

The composite of bone morphogenetic protein-2 and poly（lactic-co-glycolic acid）-trica｜cium phosphateplus different vascularized tissues to repair large segmental radial defects in sheep

作　　者：徐建强[1] 周密[1] 张树明[1] 李长庚[1] 杨飞[1] 孙锁柱[1] 王长江[1] 王克利[1] 

机构地区：[1]第二炮兵总医院骨科,北京100088

出　　处：《中华创伤骨科杂志》2012年第8期697-702,共6页Chinese Journal of Orthopaedic Trauma

基　　金：全军“十一五”医药卫生科研基金（06G018）

摘　　要：目的探讨复合骨肜态发生蛋白2的聚乳酸-乙醇酸共聚物／磷酸三钙（PLCA-TCP-BMP-2）人T骨结合不同自体带血供组织移植修复羊桡骨大段骨缺损的效果。方法将3（）只绵誊制作成30niill桡骨骨缺损模型，随机分为5组：PLGA-TCP-BMP-2人工骨及带血供的长段尺骨组（A组）、PLGA-TCP-BMP-2人工骨及带血供的屈指长肌肌腹组（B组）、PLGA-TCP-BMP-2人工骨及带血供的尺骨骨膜组（C组）、PLGA-TCP．BMP-2人工骨组（D组）及不植入任何材料组（E组），每组6强各组均以钢板㈣定桡骨缺损区。术后当天及4、12、24周行手术部位x线摄片，术后24周处死动物iiCT及组织学榆盘：结果X线片及CT检查显示：术后24周A、B、C组桡骨缺损处完全成骨修复，皮质骨与髓腔的轮廓清晰；D组亦能完全修复，但新生骨密度及髓腔轮廓清晰度均不如前3组；E绀无仃效骨痂形成。Samantha放射学评分和Lane-Sandhu放射学评分显示：A组评分高于其他4组，差异均肓统计学意义（P〈0．05）。组织学检查结果显示：A组新生骨完全修复骨缺损区；B、C组新生骨与断端皮质骨融合，新生骨痂较为纤细；D组新生板层骨及骨陷窝排列较为紊乱；E组无骨连接表现。A、B、C、D、E组Lane-Sandhu组织学评分平均分别为（11．3±0．6）、（10．8±0．8）、（10．7±0．9）、（10．2±1．1）、（4．5±1．2）分．5组比较差异有统计学意义（F=5．891，P=0．026），其中A组评分高于其他4组，差异均有统计学意义（P〈0．05）。结论PLGA-TCP-BMP-2人工骨结合不同自体带血供组织移植能满意修复羊桡骨30mm的骨缺损。Objective To study effects of tile artificial eomposite bone of bone morphogenetic pro- tel n （ B M P-2 ） and poly （ lactic-co-glyeolic acid ） -tricalcium phosphate （PLGA-TCP） with different vascularized tissues on repairing the large segmental radial defects in sheep. Methods Defects of 30 mm were made in the middle radial segments in 30 sheep which were randomized into 5 groups. In group A, the composite of BMP-2 and PLGA-TCP and vascularized ulna were implanted into the radial defects. PLGA-TCP-BMP-2 anti vascularized long digital flexor were implanted into the radial defects in group B. PLGA-TCP-BMP-2 and vascularized ulnar periosteum were implanted in group C. Only PLGA-TCP-BMP-2 was implanted in group D. No material was implanted in group E. Plates were used to fix the bone defects in all groups. X ray was used to evaluate the repairing effc＇cts at O, 4, 12, and 24 weeks postoperatively. Animals were sacrificed 24 weeks afttq＂ operation for CT analysis and histological evaluation. Samantha and Lane-Sandhu radiological and his- tological scoring systems were used for evaluation. Results CT and X ray revealed that the bone defects were fully r^paired 24 weeks a｜ier operation with clear contour of cortical bone and medullary cavity in groups A. B and C. in group I）. the contour was not as clearly as in groups A, B and C. No effective callus wasfound in group E. The Samantha and Lane-Sandhu radiological scoring revealed that group A was significantly better than the other groups （ P 〈 0. 05） . Evaluation of the morphologic features of the regenerating bone showed that active osteogenesis occurred at the site of bone defect and complete bony union was observed in group A. In groups B and C, corporation between new bone and fracture site could be seen but the lamellar bone was rather slim. In group D, new lamellar bone and lacuna were found in a deranged alignment. In group E, deranged collagenous fibrous tissue, instead of osseointegration, was found at the site of bone defect. The Lane

关 键 词：骨形态发生蛋白类 桡骨 植入物 实验性 骨缺损 

分 类 号：R687.3[医药卫生—骨科学]