实现支架材料在修复大段骨缺损时的早期血管化  

Early vascularization of scaffold materials in the repair of large bone defects

作　　者：赵胜利[1] 史本超[1] 殷杰 高浚淮 于庆贺 闵少雄[1] Zhao Shengli;Shi Ben-chao;Yin Jie;Gao Junhuai;Yu Qinghe;Min Shaoxiong(Department of Spine Surgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510220,Guangdong Province,China;Department of Hand Surgery,Ningbo City Sixth Hospital,Ningbo 315040,Zhejiang Province,China)

机构地区：[1]南方医科大学珠江医院脊柱外科,广东省广州市510220 [2]宁波市第六医院手外科,浙江省宁波市315040

出　　处：《中国组织工程研究》2018年第34期5534-5539,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省自然科学基金(2017A030313564;2014A030313348);广州市科技计划项目(201607010266)~~

摘　　要：背景:传统骨填充材料因内部缺乏完善的血管网络,致使其在修复大段骨缺损时效果欠佳。近年来研究逐渐从组织工程支架材料入手,以期解决骨科支架材料在组织工程骨血管化中应用的关键问题。目的:总结近年来组织工程支架材料在修复大段骨缺损中促进支架内部早期血管化的方法和进展,提出目前存在的问题及下一步研究的重点。方法:以"支架材料,组织工程,骨缺损修复,血管化"为中文关键词,以"scaffold,tissue engineering,bone defect repair,vascularization"为英文关键词检索CNKI、万方以及PubMed、Medline数据库有关支架材料在促进组织工程骨血管化的相关文献,总结支架材料在组织工程骨血管化中的应用现状,分析存在的问题及前景。结果与结论:共纳入43篇文献进行综述。(1)应用于组织工程骨血管化的支架材料种类繁多,各有优缺点;(2)通过优化支架材料自身几何学参数、改善材料组成成分、利用巨噬细胞介导的免疫机制、构建活性成分控释系统等均可促进组织工程材料内部血管化进程;(3)尽管目前材料学发展迅猛,但促进组织工程骨血管化的理想支架材料尚未出现;(4)细胞-支架材料相互作用及巨噬细胞在调制移植物局部血管生成的分子学机制尚未明确;(5)控释技术在实际应用过程中其有效性及安全性仍存争议,这些问题值得今后深入研究与探索。BACKGROUND:Because of the lack of perfect vascular network,traditional bone filling materials yield poor outcomes in repairing large bone defects.In recent years,there is an increasing concern on tissue engineering scaffold materials in order to achieve the early vascularization of scaffold materials in the repair of large bone defects.OBJECTIVE:To summarize the methods and progress of tissue engineering scaffold materials in promoting early vascularization in the repair of large bone defects in recent years,and to point out the existing problems and the key points of further research.METHODS:Using“scaffold material,tissue engineering,bone defect repair,vascularization”as the key words in Chinese and English,respectively,we searched CNKI,WanFang,PubMed and Medline databases for articles addressing the pro-vascularization of tissue-engineered bone.The application of scaffold materials in the vascularization of tissue-engineered bone was summarized and the existing problems and prospects were analyzed.RESULTS AND CONCLUSION:A total of 43 articles were reviewed.A variety of scaffolds with advantages and disadvantages have been used in the vascularization of tissue-engineered bone.The internal vascularization of tissue engineering materials can be promoted by optimizing the geometric parameters of scaffolds,improving the composition of scaffolds,utilizing macrophage-mediated immune mechanism and constructing active component controlled release system.Although material science is developing rapidly at present,ideal scaffold materials for promoting vascularization of tissue-engineered bone have not emerged.The molecular mechanism of cell-scaffold interaction and macrophage angiogenesis in the modulation of grafts has not been clarified.The effectiveness and safety of controlled-release technology are still controversial in the clinical practice,which is worth further explorations.

关 键 词：支架材料 骨组织工程 骨缺损修复 血管化 细胞-支架界面 巨噬细胞 免疫机制 控释 超声 组织支架 组织工程 骨与骨组织 

分 类 号：R318[医药卫生—生物医学工程]