局部应用生长因子促进颅骨缝牵引成骨的实验研究  

Effect of Local Application of Growth Factors on Osteogenesis of Cranial Suture under Distraction

作　　者：李东[1] Sean Shih-Yao Liu 黄晓翔[1] 徐海淞[1] 韦敏[1] 

机构地区：[1]上海市第九人民医院整复外科,上海200011 [2]印第安纳大学口腔颌面及正畸遗传学部

出　　处：《现代生物医学进展》2015年第26期5006-5010,共5页Progress in Modern Biomedicine

基　　金：上海市科委科研项目(134119a2000);上海市临床医学重中之重课题资助

摘　　要：目的:研究局部应用富血小板血浆及人重组BMP2对颅缝牵引成骨的作用,并用Micro-CT进行影像学评价,为进一步了解生长因子对颅缝的改建作用提供依据。方法:将30只雄性6周龄的新西兰白兔随机分为3组:(0)对照组,(1)富血小板血浆组(PRP),(2)富血小板血浆结合10μg rhBMP-2组(PRP/rhBMP-2)。用镍钛牵开弹簧给予兔矢状颅骨缝持续200 g等张牵引力牵引33天。牵引结束后,采集所有兔矢状颅骨缝标本行Micro CT精细扫描及三维重建及硬组织切片观察成骨情况。结果:Micro CT重建兔矢状颅骨缝显示,对照组和PRP组的骨缝牵开,骨缝牵开体积比PRP/rhBMP-2凝胶组大(P<0.05)。PRP的局部应用不仅促进了骨缝间的新骨形成,而且加速骨缝纤维组织的创伤愈合。PRP/rhBMP-2组牵引后骨缝可见有新骨再生及骨缝融合现象。PRP/rhBMP-2凝胶组平均骨缝融合程度约为颅骨厚度的15.3±9.5%。实验前后PRP/rhBMP-2凝胶组治疗区颅骨平均厚度较对照组和PRP凝胶组有增厚表现(P<0.05)。结论:PRP和PRP/rhBMP-2的局部应用都能有效促进骨缝牵引成骨时新骨加速形成。Micro CT显示:PRP凝胶可以诱导骨缝骨形成并加速了骨缝伤口的愈合,缝形态存在;PRP/rhBMP-2组新骨再生导致了骨缝牵引时过早产生了骨缝融合现象,提示今后在骨缝牵引成骨临床应用时需要避免高浓度生长因子在骨缝局部应用而导致的骨缝早闭。Objective： To verify the effect of PRP and its combination with rhBMP-2 as a controlled delivery system during sagit- tal suture distraction osteogenesis. Methods： Thirty six-week white rabbits were randomly assigned to sagittal suture distraction osteogenesis groups treated with group one PRP gel alone; and group two PRP gel mixed with 10 p,g rhBMP-2 （PRP/rhBMP-2）, and a control group untreated. The suture morphology was evaluated by Micro-CT and histology. Results： The amount of suture separation in the control group and the PRP gel group were statistically greater （P〈0.05） than in the PRP/rhBMP-2 gel group. The average degree of suture fusion in the PRP/rhBMP-2 gel group was 15.3 ±9.5 % of bone thickness. And the average thickness of cranium bone in the PRP/rhBMP-2 gel group was statistically greater （P〈0.05） than in the control group and the PRP gel group. Conclusion： This study showed that both PRP gel and PRP/rhBMP-2 gel are effective in improving new bone formation in suture distraction osteogenesis. PRP gel induces suture bone formation without suture fusion and accelerates the suture wound healing, while the PRP/rhBMP-2 gel group, in which the sutures fused prematurely, showed powerful bone formation ability aided by rhBMP-2.

关 键 词：富血小板血浆 骨形态发生蛋白-2 MICRO-CT 骨缝牵引成骨 

分 类 号：Q95-3[生物学—动物学] R783[医药卫生—口腔医学]