三种不同尺寸不规则45S5生物玻璃颗粒修复骨缺损的实验研究  

Experimental research on irregular 45S5 bioactive glass granules with 3 different sizes in repairing bone defects

作　　者：高鹏[1] 王臻[1] 张浩强[1] 吴畅 刘云[1] 肖鑫[3] 

机构地区：[1]第四军医大学西京医院全军骨科研究所,西安710032 [2]解放军第四二二中心医院肿瘤科,广东524000 [3]第四军医大学西京医院肿瘤科,西安710032

出　　处：《中国骨与关节杂志》2015年第1期54-60,共7页Chinese Journal of Bone and Joint

基　　金：国家自然科学(31170914)

摘　　要：目的：评价三种不同尺寸的不规则45S5生物玻璃颗粒对骨缺损的修复效果。方法24只成年新西兰大白兔，根据植入材料的不同随机数表法分为4组，每组6只12侧。A 组植入90～300μm 的材料；B组植入300～500μm的材料；C组植入500～720μm的材料；D组为空白对照组。双侧股骨髁部制造直径0.6 cm，深1.2 cm的缺损。于术后第6周和12周取材，通过大体观察、X线片、组织病理学VG染色来评价不同尺寸不规则生物活性玻璃颗粒的骨缺损修复能力和降解性能。结果所有实验兔造模成功，24只均于手术2～4h内苏醒，活动良好；二便无异常；对外界刺激灵敏；伤口愈合情况好，均为I期愈合；无炎症反应；均未见软组织异常；膝关节腔内无明显积液，滑膜光滑平整，未发现漏出的材料颗粒；股骨髁周围未发现多余的骨破坏，未见异常炎性纤维包块。成骨能力：（1）术后6周，A、B、C组可见新骨生成且向材料内部生长，D 组基本没有新骨形成，可见肉芽组织形成；术后12周，A、B、C 组成骨量显著增多，大部分骨缺损愈合，可见成熟的骨小梁塑形。（2） Lane-Sandhu X射线评分：术后6周，A、B、C三组评分（4.827±0.277）分、（5.128±0.448）分、（7.104±0.477）分均高于D组（0.831±0.081）分（ P＜0.05），且C组评分高于A、B组（ P＜0.0001），而A组评分与B组相差不大（ P＝0.193）；术后12周，A、B、C各组的评分（8.011±0.159）分、（8.023±0.197）分、（10.974±0.106）分均较术后6周明显增高（ P＜0.0001），A、B、C 三组评分仍高于 D 组（1.397±0.262）分（ P＜0.05），C 组高于 A、B 组（ P＜0.0001），A 组评分与 B 组仍相差不大（ P＝0.805）。（3）组织学观察成骨能力结果：术后6周，新生骨量所占切片的百分比，A、B、C 三组（10.837±0.856）%、（10.762±1.008）%、（17.399±0.515）%均大于D组（1.048±0.127）%�Objective To evaluate the effects of irregular 45S5 bioactive glass granules with 3 different sizes in repairing bone defects.Methods A total of 24 adult New Zealand white rabbits were randomly assigned into 4 even groups, with 12 hind legs in each group. In group A, 90-300 μm granules were implanted and 300-500 μm granules＆amp;nbsp;were implanted in group B, and while the rabbits in group C were implanted with 500-720 μm granules. Nothing was implanted in Group D, which was taken as the control group. The defects with the depth of 12 mm and the diameter of 6mm were made in bilateral femoral condyles of each rabbit. The sample was taken at 6 and 12 weeks after the operation. The osteogenic potential and biodegradation property of irregular bioactive glass granules with different sizes were evaluated through the general observation, X-ray and Van-Greson staining （ VG staining ）.Results All the rabbits woke up at 2-4 h after the operation, and their activities were restored, with normal bowel and bladder function. They were sensitive to external stimulation. Primary wound healing was achieved in all the rabbits, without inflammatory responses or abnormal soft issues. No obvious effusion was noticed in the knee joint cavity, and the synovium was smooth and complete. There were no residual granules. No extra bone destruction was found around the femoral condyle, and there were no abnormal inlfammatory and ifbrous masses. At 6 weeks after the operation, new bone began to grow towards the internal materials in groups A, B and C, but there was no new bone formation in group D, except for some granulation tissues. At 12 weeks after the operation, a signiifcant increase in the bone mass was detected in group A, B and C, and most bone defects got repaired. The mature bone trabecula could be seen. At 6 weeks after the operation, the Lane-Sandhu X-ray scores were （ 4.827±0.277 ） points, （ 5.128±0.448 ） points and （ 7.104±0.477 ） points in groups A, B and C, which were higher than （ 0.831±0.081 ）

关 键 词：生物相容性材料 玻璃 修复外科手术 骨缺损 

分 类 号：R318.08[医药卫生—生物医学工程]