重组人骨形态发生蛋白2在退变性颈腰椎疾病手术融合中骨诱导影响的临床研究  

Clinical study on the influence of rh BMP-2 on bone induction in surgical fusion of degenerative cervical and lumbar diseases

作　　者：李谦 于海泉[1] 杨艳[1] 王欣[1] LI Qian;YU Hai-quan;YANG Yan(Department of Orthopedics,The First Hospital of Shijiazhuang,Shijiazhuang Hebei 050011,China.)

机构地区：[1]石家庄市第一医院骨科

出　　处：《临床和实验医学杂志》2019年第18期1985-1988,共4页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究重点计划项目(编号:20160793)

摘　　要：目的观察重组人骨形态发生蛋白2(rh BMP-2)在退变性颈腰椎疾病手术融合中对骨诱导的影响,同时评价其临床应用价值。方法应用回顾性研究法,选择2016年1月至2017年12月石家庄市第一医院收治的134例退变性颈腰椎疾病患者作为研究对象,所有患者均行脊柱植骨融合术治疗,根据植骨融合材料的不同,将其分为3组,A组患者(n=44)应用自体骨,B组患者(n=45)应用同种异体骨,C组患者(n=45)应用rh BMP-2,比较三组患者在不同时间节点(术前、术后6个月、术后12个月)的椎间隙高度、腰腿部疼痛视觉模拟评分(VAS)、日本骨科学会(JOA)评分、植骨融合情况以及临床疗效。结果 A组、C组患者术后12个月的椎间隙高度、腰腿部VAS评分、JOA评分均要优于B组[(1. 22±0. 33)分vs.(1. 24±0. 35)分vs.(1. 01±0. 28)分、(1. 57±0. 36)分vs.(1. 59±0. 37)分vs.(2. 59±0. 49)分、(27. 59±3. 65)分vs.(27. 59±3. 59)分vs.(25. 35±3. 69)分],差异均具有统计学意义(P <0. 05);A组、C组患者术后6、12个月的植骨融合率均要高于B组[(86. 4%vs. 82. 2%vs. 42. 2%],差异均具有统计学意义(P <0. 05);A组、C组患者随访12个月的临床治疗优良率高于B组[97. 7%vs. 93. 3%vs. 64. 4%],差异均具有统计学意义(P <0. 05)。结论 rh BMP-2在退变性颈腰椎疾病手术融合中对骨诱导的影响基本与自体骨等同,较同种异体骨表现出较大的优势;应用rh BMP-2骨诱导效果好、融合快、成功率高,且可以避免有创取材,体现出较高的临床应用价值。Objective To observe the influence of recombinant human bone morphogenic protein 2 (rhBMP-2) on bone induction during surgical fusion of degenerative cervical and lumbar diseases, and to evaluate its clinical significance. Methods A retrospective study was conducted to select 134 patients with degenerative cervical and lumbar diseases admitted to this hospital during January 2016 to December 2017. All these patients underwent spinal fusion and bone graft fusion. They were divided into three groups. Patients in Group A (n=44) applied with autologous bone, patients in group B (n=45) applied with allogeneic bone, and patients in group C (n=45) applied with rhBMP-2. The height of the intervertebral space, the visual analog scale (VAS) scores of lower back pain, the Japanese Orthopaedic Association (JOA) scores, and the bone graft were compared between these three groups of patients at different time points (preoperative, 6 months, and 12 months after surgery) for integration and clinical efficacy. Results Twelve months after surgery, the vertebral space height, VAS and JOA scores in both group A and group C were better than those of group B [(1.22±0.33) scores vs.(1.24±0.35) scores vs.(1.01±0.28) scores,(1.57±0.36) scores vs.(1.59±0.37) scores vs.(2.59±0.49) scores,(27.59±3.65) scores vs.(27.59±3.59) scores vs.(25.35±3.69) scores], and the difference was statistically significant ( P <0.05). The bone graft fusion rates of group A and group C in 6 months and 12 months after surgery were higher than those of group B [86.4% vs. 82.2% vs. 42.2%], and the difference was statistically significant ( P <0.05). The excellent and good rate of clinical treatment in group A and group C was higher than that in group B [97.7% vs. 93.3% vs. 64.4%], and the difference was statistically significant ( P <0.05). Conclusion The effect of rhBMP-2 on bone induction for surgical fusion of degenerative cervical and lumbar discs is basically same as that of autologous bone, which shows a greater advantage than that of allogeneic bon

关 键 词：退变性颈腰椎疾病 脊柱融合术 重组人骨形态发生蛋白2 骨诱导 

分 类 号：R687.3[医药卫生—骨科学]