硫酸葡聚糖/重组人BMP-2/壳聚糖复合微球联合珊瑚羟基磷灰石人造骨修复大段骨缺损影像学评价  

Radiological evaluation of dextran sulfate/recombinant human bone morphogenetic protein 2/chitosan composite microspheres combined with coral hydroxyapatite artificial bone in repairing large segmental bone defects

作　　者：陈泽鹏 章莹[1,2] 林泽枫 叶翔凌 张永强 夏远军[1,2] 夏虹 尹庆水 

机构地区：[1]中国人民解放军广州总医院骨科医院,广州510010 [2]广州中医药大学研究生院,广州510405

出　　处：《中国修复重建外科杂志》2017年第11期1384-1389,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金青年基金资助项目(51303031);广州市科技计划项目(201607010268;2013J4100120)~~

摘　　要：目的通过影像学表现评价硫酸葡聚糖/重组人BMP-2/壳聚糖(dextran sulfate/recombinant human BMP-2/chitosan,DS/rh BMP-2/CS)缓释微球联合珊瑚羟基磷灰石(coral hydroxyapatite,CHA),修复大段骨缺损的成骨效果。方法取57只24周龄雄性新西兰大白兔,制备右桡骨20 mm长骨缺损模型。将其中54只兔随机分为3组(n=18),A、B、C组分别将CHA、DS/rh BMP-2/CS/CHA和rh BMP-2/CHA人工骨植入骨缺损区域中;余3只兔不植入材料作为空白对照组。术后观察动物大体情况;术后4、8、12周取材行X线片观察,Micro-CT扫描及三维重建获取新生骨体积。结果实验动物术后恢复良好,大体情况正常。X线片观察示,B组术后各时间点骨愈合情况均优于A、C组;术后各时间点B组X线片评分显著高于A、C组(P<0.05);术后8、12周C组评分高于A组(P<0.05)。Micro-CT扫描及三维重建观察示,术后各时间点A组骨缺损区新生骨组织少,成骨形态差;B组新生骨组织多,骨缺损区骨塑形良好,12周时逐渐接近正常骨形态;C组骨缺损区新生骨组织较多,成骨形态一般。术后各时间点B组新生骨体积均显著高于A、C组(P<0.05),术后8周C组评分高于A组(P<0.05)。结论 DS/rh BMP-2/CS/CHA缓释人工骨的成骨效果明显优于单纯CHA和rh BMP-2/CHA,为未来应用骨组织工程方法临床治疗骨缺损提供了新思路。Objective To evaluate the osteogenic effect of dextran sulfate/recombinant human bone morphogenetic protein 2/chitosan（DS/rh BMP-2/CS） combined with coralline hydroxyapatite（CHA） in repairing large segmental bone defects by radiographic feature. Methods Fifty-seven 24-week-old male New Zealand rabbits were prepared for establishing right radius bone defect model of 20 mm in length. In which 54 rabbits were randomly divided into 3 groups（n=18）, and the CHA, DS/rh BMP-2/CS/CHA, and rh BMP-2/CHA artificial bone grafts were implanted into the bone defect in groups A, B, and C respectively; the remaining 3 rabbits were implanted nothing as blank control group.After operation, the gross condition of the animals was observed; at 4, 8, and 12 weeks after operation, X-ray film observation, Micro-CT scanning, and three-dimensional reconstruction were performed to obtain the volume of the new b one. Results The experimental animals recovered well and were in normal condition. X-ray observation showed thatthe bone healing in group B was better than that in groups A and C at each time point. At each time point after operation,the X-ray scores of group B were significantly higher than that of group A and group C（P0.05）; the scores of group C at8 and 12 weeks after operation were significantly higher than that of group B（P0.05）. Micro-CT scanning and threedimensional reconstruction observation showed that at each time point after operation in group A, the bone defect area had less bone formation and poor osteogenesis; in group B, there were many new bone tissues in bone defect area, and the bone remodeling was well, and gradually closed to normal bone morphology at 12 weeks; in group C, there were many new bone tissues in bone defect area, but the bone formation was general. The new bone volume of group B was significantly higher than that of group A and group C（P0.05） at each time point after operation, and the score of group C was higher than that of group A at 8 weeks after operation（P0.05）. Concl

关 键 词：硫酸葡聚糖 重组人BMP-2 壳聚糖 珊瑚羟基磷灰石 骨缺损 影像学 

分 类 号：R68[医药卫生—骨科学]