自体富血小板血浆混合磷酸钙骨水泥修复椎体骨缺损的实验研究  

Experimental study of autologous platelet-rich plasma in combination with calcium phosphate cement in repairing vertebral bone defect

作　　者：郭瑛 贾连顺[2] 吴维敏[3] 张力军 邢国 彭波 吴柏 GUO Ying;JIA Lianshun;WU Weimin;ZHANG Lijun;XING Guo;PENG Bo;WU Bo(Department of Spine Surgery,No.187 Central Hospital of PLA,Hainan Province,Haikou 571159,China;the Third Department of Spinal Surgery,Changzheng Hospital Affiliated to the Second Military Medical University,Shanghai 200003,China;Department of General Surgery,No.187 Central Hospital of PLA,Hainan Province,Haikou 571159,China;Department of Anesthesiology,No.187 Central Hospital of PLA,Hanian Province,Haikou 571159,China;Department of Traumatic Orthopedics,No.187 Central Hospital of PLA,Hainan Province,Haikou 571159,China)

机构地区：[1]解放军第一八七中心医院脊柱外科,海南海口571159 [2]第二军医大学附属长征医院脊柱三科,上海200003 [3]解放军第一八七中心医院普通外科,海南海口571159 [4]解放军第一八七中心医院麻醉科,海南海口571159 [5]解放军第一八七中心医院创伤骨科,海南海口571159

出　　处：《中国医药导报》2018年第25期13-16,28,共5页China Medical Herald

基　　金：海南省自然科学基金面上项目(20168345);吴阶平医学基金会临床科研专项资助基金课题(320-2745-16-263)

摘　　要：目的观察自体富血小板血浆(PRP)与磷酸钙骨水泥(CPC)混合物修复椎体骨缺损的效果。方法选取山羊18只,在每只羊L_1~L_6椎体侧方制备6 mm×10 mm圆柱形骨缺损。根据填充方法的不同将实验分为三组:实验组填充自体PRP复合CPC,对照组填充CPC,假手术组不填充。于术后1、3、6个月随机处死6只,通过影像学观察骨愈合情况。结果所有动物均顺利完成手术并存活。PRP中血小板数量约为全血中血小板量的5倍余,PRP中生长因子[血小板衍生生长因子(PDGF)、转化生长因子β(TGF-β)、血管内皮生长因子(VEGF)]的含量明显高于全血中生长因子含量(P<0.05)。在术后各时间节点,实验组与对照组均有新生骨形成及骨水泥吸收,但实验组更明显,而假手术组空洞未见明显骨修复。结论 PRP能释放大量的生长因子,与CPC混合后表现出很好的骨诱导和成骨性能。两者混合物用于椎体骨缺损时效果确切。Objective To observe the effect of the mixture of autologous platelet-rich plasma（PRP） and calcium phosphate cement（CPC） in repairing vertebral bone defect. Methods 18 goats were included in this experiment. A 6 mm ×10 mm cylindrical bone defect was prepared on the side of lumbar vertebral body（L_1-L_6） of each sheep. The experiment was divided into three groups according to different filling methods： the experimental group was filled by CPC in combination with PRP, the control group was filled with CPC, and the sham operation group was not filled. 6 goats were randomly executed after surgery for 1, 3, 6 months, then the bone healing conditons were observed by imaging examination. Results All animals successfully completed surgery and survived. The platelet count in PRP was about 5 times more than that in whole blood, and the contents of growth factors [platelet derived growth factor（PDGF）,transforming growth factor-β（TGF-β）, vascular endothelial growth factor（VEGF）] in PRP were significantly higher than those in the whole blood（P 〈 0.05）. In all time points after surgery, new bone formation and cement absorption could be observed in both experimental group and control group, but the experimental group was more obvious, while no significant bone repair sign could be seen in sham operation group. Conclusion PRP can release a large number of growth factors, and show great properties of osteoinductive and osteogenesis when combined with CPC. The composite is effective for the treatment of vertebral bone defect.

关 键 词：磷酸钙 富血小板血浆 椎体骨缺损 动物模型 羊 

分 类 号：R683.2[医药卫生—骨科学]