富血小板血浆联合骨髓间充质干细胞治疗家兔股骨头缺血坏死的研究  

Comparative study of treating avascular necrosis of femoral head in rabbits with bone mesenchymal stem cells banding with platelet-rich plasma

作　　者：胡钟旭[1] 李东卿[1] 李贵涛[2] 杜恒胜[1] 

机构地区：[1]南方医科大学附属中山博爱医院骨科,广州528400 [2]广东省第二人民医院骨科,广州510000

出　　处：《中华损伤与修复杂志（电子版）》2014年第1期22-26,共5页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：广东省自然科学基金(7301061)

摘　　要：目的评价比较富血小板血浆(PRP)联合骨髓间充质干细胞(BMSCs)移植修复家兔激素性股骨头缺血坏死与单纯BMSCs移植效果。方法选取2只家兔自股骨骨髓离心提取BMSCs。选取40只家兔制作股骨头缺血坏死模型后,根据股骨头坏死临床诊断标准选取处于股骨头坏死Ⅰ、Ⅱ期阶段的30只家兔随机分为3组,每组10只。第一组10只患肢行钻孔减压后接受PRP联合BMSCs治疗(PRP联合BMSCs治疗组);第二组10只患肢行钻孔减压后只接受单纯BMSCs治疗(单纯BMSCs治疗组);第三组10只作为空白对照组,患肢行钻孔减压后接受注射用0.9%氯化钠溶液治疗。实验结果观察包括:治疗1周后利用聚合酶链反应检测各组转录生长因子(TGF-β)以及血管内皮生长因子(VEGF)含量;治疗5周后行切片分析以及BMSCs生长周期测定。结果聚合酶链反应结果显示,PRP联合BMSCs治疗组分别与单纯BMSCs治疗组以及空白对照组比较,TGF-β的表达量存在差异,并具有统计学意义(3组间TGF-β含量分别为:1.5±0.46、1.2±0.36、0.4±0.12,P<0.01),VEGF的表达量存在差异,并具有统计学意义(3组间VEGF含量分别为:1.5±0.72、1.1±0.43、0.8±0.21,P<0.01);细胞周期测定显示PRP联合BMSCs治疗组与单纯BMSCs治疗组以及空白对照组相比,处于G1期数目较少,具有统计学意义(3组经治疗后处于G1期BMSCs的比例分别为:40%、60%、70%,P<0.05)。结论实验证明,PRP可以促进TGF-β以及VEGF的分泌,并且可以通过促进TGF-β以及VEGF的分泌对BMSCs的增殖有促进作用。与单纯BMSCs治疗相比,PRP联合BMSCs治疗股骨头缺血坏死可能是一种更有效的治疗方法。Objective Evaluated whether transplantation of pure mesenchymal stem cells （BMSCs）banding with platelet-rich plasma （PRP） is better than pure BMSCs for the treatment of rabbit osteonecrosis of femoral head.Methods Two rabbits were selected as the source of BMSCs Another 40 rabbits were used for the experiment to establish the model of osteonecrosis of femoral head.After the success of the found of the model,30 of them chosed were divided into 3 groups：the BMSCs ＋ PRP group （Bone Mesenchymal cells banding with PRP injected after core decompression）,the BMSCs group （Mesenchymal stem cells injected after core decompression）,and the non treated group （Injected saline after core decompression）.Outcome measure included reverse transcription-polymerase chain reaction to detect expression of transforming growth factor-β （TGF-β）and vascular endothelial growth factor（VEGF） 1 week after transplantation; 5 weeks after transplantation the authors carried out histological analysis and analysed of the cell cycle.Results Expression of TGF-βand VEGF in the BMSCs ＋ PRP group was significantly increased compared with that in the other groups at 7 days after the injection （TGF-β：1.5 ± 0.46 vs 1.2 ± 0.36 vs0.4±0.12,P＜ 0.01; VEGF：1.5 ±0.72 vs 1.1 ±0.43 vs 0.8 ±0.21,P＜ 0.01） ;Histology section analysis showed that in the BMSCs ＋ PRP and BMSCs groups,there were formation of new bone tissures,however in the BMSCs ＋ PRP group,there were more new bony tissure.Lane-Sandhu scaling furtherly confirmed the results.The percentages of cells in the G1 phase of the cell cycle in the femurs of rabbits treated with BMSCs alone or untreated were high compared to rabbits.Treated with BMSCs ＋ PRP （40％ vs 60％ or 70％,P ＜ 0.05）.Conclusions Transplantation of BMSCs banding with PRP may be a better and more available treatment for osteonecrosis of femoral head than pure BMSCs.

关 键 词：富血小板血浆 骨髓 间质干细胞 股骨头坏死 组织工程 

分 类 号：R681.8[医药卫生—骨科学]