rhBMP-2/CHA修复甲状软骨缺损的实验研究  

Repair of Throat Thyroid Cartilage Defects with rhBMP-2/CHA

作　　者：张龙城[1] 胡万青[2] 林文彪[1] 曹高翔[3] 黄海波[1] 夏薇[3] 陆梦漪 韦干观[1] 

机构地区：[1]中国人民解放军第303医院耳鼻咽喉头颈外科,南宁530021 [2]安徽省马鞍山市人民医院耳鼻咽喉科,马鞍山243000 [3]广西大学材料科学与工程学院,南宁530004

出　　处：《华中科技大学学报（医学版）》2014年第3期316-320,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：全军医药卫生科研资助项目(No.06MA122);广西自然科学基金资助项目(No.2011GXNSFA018209)

摘　　要：目的寻找一种修复甲状软骨缺损的新支架材料。方法以重组人骨形态发生蛋白2（rhBMP-2）、I型胶原-羟基磷灰石（CHA）为材料，运用计算机辅助设计／计算机辅助制造（CAD／CAM）技术和快速成型技术，采用泡沫凝胶注模法制备不同羟基磷灰石（HA）含量（60％、50％、40％体积分数）的甲状软骨支架，检测其孔隙率，扫描电镜观察其孔隙大小。选取27只新西兰大白兔，随机分为3组，切除一侧甲状软骨板，A组为缺损区植入rhBMP－2／cHA复合支架，B组为缺损区植入CHA支架，C组为缺损区填塞明胶海绵作空白对照。分别于术后1、3、7周各组随机抽取3只兔取材行大体观察和组织病理学检查。结果HA体积分数为50％的支架孔隙率为（50．54±3．02）％，其抗压强度为（2．50±0．24）MPa，孔隙结构主要以100～200μm的内部联通的球状孔洞为基本特征。术后3周，3组材料均完全降解，A组可见少量半透明状的骨性结节，B组见较多纤维结缔组织生成而末见骨样组织形成；术后7周，A组缺损区有块状骨性组织生成，切面呈黄白色，质地较硬，新生骨质与对侧未切除甲状软骨边缘紧密结合，B组缺损区仍只见纤维结缔组织覆盖。组织病理学检查显示：A组7周术区软骨母细胞增生伴成软骨区域形成，可见软骨细胞增生及软骨骨质形成；B组、C组术区见成熟的纤维细胞增生，均未见软骨细胞及成熟骨细胞生成。结论HA体积分数为50％的支架与rhBMP2及I型胶原复合的材料具有良好的组织相容性和骨诱导作用，为甲状软骨缺损的修复和重建提供了一种新的支架材料。Objective To find a new scaffold material for repair of thyroid cartilage defects. Methods The thyroid cartilage scaffold containing different contents of hydroxyapatite （HA） （volume fraction： 60 % , 50 % and 40 % ） was prepared by foam-gel injection molding by using computer-aided design/computer-aided manufacturing （CAD/CAM） technology and rapid prototy ping （RP） technology,with recombinant human bone morphogenetic protein 2 （rhBMP-2）,type I collagen HA（CHA） as materials. The porosity of thyroid cartilage scaffolds was detected. The size of the pore was observed by scanning electron micros copy. A total of 27 New Zealand white rabbits were randomly divided into three groups and removed of one side of the thyroid cartilage . group A,in which the defect area was implanted with rhBMP 2/CHA composite scaffold;group B,in which the CHA bracket was used for implantation;group C,in which the gelatin sponge was filled. The implants were removed from 3 rabbits 1, 3 and 7 weeks after surgery, respectively,in each group, for gross observation and histological examination. Results When 50% HA was used, the porosity of thyroid cartilage scaffolds was （50.54 ± 3.02）%, the compressive strength was （2.50 ± 0.24） MPa and the scaffolds were characterized by interconnected spherical pores at a size of 100 to 200 /~m. The scaffold material was completly degraded in all the 3 groups 3 weeks after operation. In group A,few translucent bone nodules were seen. In group B, more fibrous connective tissues were developed in the absence of osteoid tissues. Seven weeks after surgery,massive bony tissues were generated in the defect area in group A,where the tissues were presented yellowish-white on the cut surface,and had hard texture, and the newborn bone was closely connected with the edge of the thyroid cartilage on the contralateral side. In group B,the defect area was only covered with fibrous connective tissues. Histological examination revealed chondroblast hyperplasia with cartilage formation,visi

关 键 词：重组人骨形态发生蛋白-2 羟基磷灰石 计算机辅助设计 计算机辅助制造 甲状软骨 修复 

分 类 号：R318.08[医药卫生—生物医学工程]