rhBMP-2联合rhVEGF165对兔前交叉韧带重建后腱-骨愈合的影响  

Effects of administration rhBMP-2/rhVEGF165 on tendon-bone healing after anterior cruciate ligament reconstruction in rabbits

作　　者：周平[1] 赵其纯[1] 尚希福[1] 王姚斐[1] 李旭[1] 纪小枫[1] 凌晓冬[1] 朱亚林[1] 

机构地区：[1]安徽医科大学附属省立医院骨科,合肥230001

出　　处：《安徽医科大学学报》2013年第5期458-462,共5页Acta Universitatis Medicinalis Anhui

基　　金：安徽省科技厅重点科研项目(编号:11070403044)

摘　　要：目的探讨局部联合应用重组人骨形态发生蛋白(rhBMP)-2和重组人血管内皮生长因子165(rhVEGF165)对兔前叉韧带重建后腱-骨早期愈合的影响。方法 78只健康成年雄性新西兰大白兔,随机分为VB、B、V、F及正常组,前4组建立双膝自体半腱肌前交叉韧带重建模型,正常组未行手术。VB组腱-骨界面注入以纤维蛋白胶(FG)为载体的rhBMP-2/rhVEGF165混合物;B组注入rhBMP-2和FG混合物;V组注入rhVEGF165和FG混合物;F组单纯注入FG。术后第2、4、8周,每组随机抽取6只兔子,右膝标本行组织学观察,左膝标本行生物力学测试。结果术后第2周:VB组腱-骨连接紧密,成纤维细胞大量增生;B组连接紧密,可见少量软骨细胞;V、F组连接疏松,主要为纤维血管组织构成。术后第4周:VB组腱-骨界面初步形成四层结构;V、B、F组则主要由成熟的成纤维细胞构成,腱-骨连接紧密,骨隧道壁出现一定量成骨反应;术后第8周:VB组四层结构更明显,可见潮线;B组骨隧道壁侧成骨反应进步加强;V、F组腱-骨界面宽度进步变窄,成纤维细胞数目明显减少。直至术后第4、8周,VB组平均最大载负荷及刚度才较V、B、F组大(P<0.05),均低于正常组;同时V、B组生物力学性能优于F组(P<0.05)。结论 rhBMP-2联合rhVEGF165对兔前交叉韧带重建术后腱-骨早期愈合具有促进作用,且联合效应强于各自单独效应。Objective To explore effects of local administration rhBMP-2/rhVEGF165 on tendon-bone ealy healing after anterior cmciate ligament reconsctruction in rabbits. Methods Seventy eight male New Zealand white rabbits were randomly divided into Group VB, B, V, F and normal group. Bilateral anterior cruciate ligaments of each animal were removed and reconstructed with autogenetic tendon of semitendinosus muscles while normal group did not receive any operation. The fibrin glue （FG） containing rhBMP-2/rhVEGF165 was injected into tendon-bone interface of Group VB. FG with rhBMP-2 was injected in Group B, FG with rhVEGF165 in Group V and only FG were used in Group F. Six animals were sacrificed randomly in each group at 2th, 4th, 8th posteoperative week respectively for right knee specimens histological examinations and left knee specimens biomechanical tests. Results After two weeks of operation, the tendon and bone were connected tightly with active proliferation of fibroblast at Group VB; some chondrocytes were observed in the tight interface of Group B; the interfaces of Group V and F consisted primarily of fibrovascular tissue with loose connection. After four weeks of operation, the interface of Group VB initially formed four-layer insertion, while those of Group B, V, and F composed mainly of mature fibroblasts with tight connection and a certain osteogenetic reaction was observed in the bone tunnel wall. After eight weeks of operation, there was more obvious four-layer insertion with tidemark in the interface of Group VB and osteogenetic reaction further progressed in the bone tunnel wall in Group B. The width of tendon-bone interface of Group V and F narrowed further and the number of fibroblasts significantly reduced. Not unitl 4 and 8 weeks after operation, were the average maximum load and stiffness of Group VB higher than thoses of Group B ,V, and F （P 〈 0.05 ）. Meanwhile, the biomechanical property of Group V and B were better than those of Group F （P 〈 0.05）. Conclusion Combined administrati

关 键 词：前交叉韧带 骨形态发生蛋白 血管内皮生长因子 腱-骨愈合 重建 

分 类 号：R686.5[医药卫生—骨科学]