一种组织工程骨与自体骨修复股骨头缺损坏死的疗效比较  

A new tissue engineered bone replaced autograft bone to repair femoral head defects and necrosis

作　　者：彭吾训[1] 张爱华[2] 王蕾[2] 郭兵[2] 吴建华[1] 邓进[1] 

机构地区：[1]贵阳医学院附属医院骨科,贵州贵阳550004 [2]贵阳医学院,贵州贵阳550004

出　　处：《中国现代医学杂志》2013年第22期6-11,共6页China Journal of Modern Medicine

基　　金：贵州省科学技术厅贵阳医学院社发联合基金项目(No:黔科合[2010]3165);贵州省科学技术基金项目(No:黔科合字[2013]2038)

摘　　要：目的探索应用组织工程技术修复股骨头缺损坏死模型的效果,并与自体骨相比较。方法制备异体脱抗原松质骨(AACB),并将其与骨形成蛋白(BMP)及碱性成纤维细胞生长因子(bFGF)复合制成AACB/BMP/bFGF复合人工骨。将30只犬60侧股骨头采用液氮冷冻建立成犬股骨头缺损坏死模型,造模后8周,随机分为5组,每组6只犬12侧股骨头,A组不植入任何材料,为空白对照;B组植入AACB;C组植入AACB/BMP;D组植入AACB/BMP/bFGF;E组植入自体松质骨。术后3周、6周及12周分批处死动物。通过大体解剖观察、X线摄片、组织学染色观察、图像分析、血管免疫组织化学染色等手段观察缺损坏死模型的修复情况。结果术后各组动物均无毒性反应和炎症反应,动物无死亡。12周时X线摄片提示:A组(空白缺损组)缺损依然清晰可见,B组(AACB组)移植区骨密度低于周围骨组织,C组(AACB/BMP组)移植区密度不均,D组(AACB/BMP/bFGF组)和E组(自体骨组)移植区骨密度与周围骨组织相当,界限不清。6周时A组新骨形成面积为(2.35±1.14)%,B组为(4.79±1.43)%,C组为(8.67±1.34)%,D组为(32.28±2.17)%,E组为(17.26±1.20)%,D组与其余各组间差异有显著性(q=589.51,P=0.00)。12周时A组骨缺损仍然存在,D组骨修复及骨改建已经完成。6周时A组(空白缺损组)血管计数为(2.50±0.58)条,B组(AACB组)为(4.25±0.96)条,C组(AACB/BMP组)为(5.75±0.96)条,D组(AACB/BMP/bFGF组)为(11.00±1.63)条,E组(自体骨组)为(8.00±0.82)条,D组与其余各组间差异有显著性(Q=45.88,P=0.00)。结论 AACB/BMP/bFGF复合人工骨具有明显促进犬股骨头缺损坏死模型再血管化及新骨形成的作用,能够代替自体骨修复股骨头缺损坏死。[ Objective ] The objective of this research was to examine whether AACB/BMP/bFGF, a new engineer- ing bone can replace autograft bone to repair the femoral head defects and necrosis in dog model. [Methods] AACB/BMP/bFGF was made by combining basic fibroblast growth factor （bFGF）, bone morphogenetic protein（BMP） with allogeneic antigen-extracted cancellous bone （AACB）. 60 femoral heads of 30 canines （1-year-old） were used to create femoral head defects and necrosis model by liquid nitrogen freezing, and were randomly divided into 5 groups （n =12 per group） at the end of 8 weeks： Group A was grafted nothing as control; Group B filled with AACB; Group C filled with AACB/BMP; Group D filled with AACB/BMP/bFGF; Group E filled with autologous cancellous bone. The specimens were harvested separately at the end of 3, 6 and 12 weeks after operation. A series of exami- nations were carried out including gross observation, radiography, histology, image pattern analysis, blood vessel im-munohistochemical staining. [ Results ] All the animals had no inflammation reaction or death. Radiological analysis indicated that, at twelve weeks, in group A, defects were still present; in group B, the density of grafted area was lower than the surrounding bone tissue; in group C, the density of grafted area was uniform; in group D and group E, the density was equivalent to the host bone and there was no clear boundary. At six weeks, the new bone forming area of group A was （2.35±1.14）%. Group B （4.79±1.43）%. Group C （8.67±1.34）%. Group D （32.28±2.17）%. Group E （17.26±1.20）%. Group D is significantly difference statistically with other groups（q =589.51, P =0.00）. By the end of 12 weeks, little new bone formed in group A and bone repairing and remodeling had completed in group D.At six weeks, vessel count of the group A （blank control group） was （2.50±0.58）. Group B （AACB group） （4.25±0.96）. Group C （AACB/BMP group） （5.75±0.96）. Group D （AACB/BMP/bFGF group）

关 键 词：股骨头缺血性坏死 碱性成纤维细胞生长因子 骨形态发生蛋白 异体脱抗原松质骨 

分 类 号：R318.08[医药卫生—生物医学工程]