组织工程骨膜同种异体体内修复兔肩胛骨大段骨缺损的实验研究  

Repair of segmental scapular defects in rabbits using allogeneic tissue- engineered periosteum

作　　者：庾佳佳 赵琳 

机构地区：[1]山西省运城市中心医院骨科,044000 [2]甘肃省骨与关节疾病研究重点实验室

出　　处：《中国矫形外科杂志》2016年第22期2083-2089,共7页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:30973064)

摘　　要：[目的]对比观察组织工程骨膜(tissue-engineered periosteum,TEP)及脱蛋白骨对兔肩胛骨大段骨缺损的修复效果,探讨组织工程骨膜通过膜内化骨修复大段不规则骨缺损的可行性。[方法]将体外分离培养的兔骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)传代扩增及成骨诱导后,与自制的猪小肠黏膜下基质(small intestinal submucosa,SIS)复合培养构建组织工程化骨膜。选取2个月龄新西兰大白兔60只,行肩胛骨次全切除术,制作大段不规则骨缺损模型。随机分为5组,每组12只:A组在骨缺损区置入TEP;B组在骨缺损区置入脱蛋白骨(deproteinization bone,DPB);C组在骨缺损区置入TEP+DPB复合体;D组、E组则分别为造模后不处理空白组和切除骨保留自身骨膜组。术后4、8、12周时,各组每次分别处死4只动物收集标本,进行X线片及组织学检测,对比分析各组肩胛骨大段骨缺损的修复效果。[结果]X线表现:不同时间段,A、C组均有相当数量的新生骨形成,密度接近正常骨。其中C组外观形态与正常肩胛骨相似,塑形好,与E组密度较接近。B组DPB逐渐被吸收,无骨缺损修复征象。D组缺损区始终无高密度影出现。组织学表现:A、C、E组4周时以多点方式形成新骨,8周时出现岛状生长的骨组织,12周时新生骨趋成熟,呈编织状排列,可见血管腔。B、D组仅为胶原瘢痕组织,无新骨生成。[结论]组织工程骨膜可修复兔肩胛骨大段骨缺损,其通过膜内化骨修复大段不规则骨缺损是可行的。[ Objective] To compare the efficacy of tissue - engineered periosteum （TEP） and deproteinized bone （DPB） in repairing segmental scapular defects in rabbits, and to investigate the feasibility of TEP in repairing segmental irregular bone defects by intramembranous ossification. [ Method] The rabbit bone marrow mesenchymal stem cells （BMSCs） cultured in vitro were induced to differentiate into osteoblasts. TEP was constructed by combining osteoblasts with porcine small intestinal submu- cosa （SIS）. Sixty two - month - old New Zealand white rabbits received subtotal scapular resection to establish the model of seg- mental irregular bone defects. All the rabbits were randomly and equally divided into 5 groups （ A - E）. Groups A, B, and C had TEP, DPB, and the complex of TEP and DPB implanted in the defect regions, respectively. Group D left the defect region un- treated, while group E retained autologous periosteum. At 4,8, and 12 weeks after surgery,4 rabbits in each group were sacrificed and the implants were harvested. X - ray radiography and histological examination were performed to evaluate the outcomes in repairing segmental scapular defects in each group. [ Result ] According to the results of X - ray radiography, group A and group C had a large amount of newly formed bone with similar density to that in normal bone at different time points; the newly formed bone in group C ,morphologically similar to the normal scapula,had goad shapes and similar density as that in group E; group B had DPB gradually absorbed and showed no sign of bone repair; group D showed no high - density shadow in the defect regionat any time. According to the results of histological examination, groups A, C, and E had a punctate distribution of newly formed bone at week 4, island - like bone formation at week 8, and nearly mature bone in a braided arrangement with visible blood vessel lumen at week 12; groups B and D only had collagen scar tissue instead of new bone formation. [ Con-clusion ] TEP can repair segmenta

关 键 词：组织工程骨膜 同种异体脱蛋白骨 肩胛骨缺损 兔 

分 类 号：R318.08[医药卫生—生物医学工程] R68[医药卫生—基础医学]