聚乳酸肋骨钉与纯钛环抱器植入动物体内后炎性反应及乳酸浓度的对比  

Inflammatory reaction and lactic acid concentration after implantation of polylactic acid rib nail versus pure titanium embracing fixator in animals

作　　者：程磊 金健[1] 胡敬国[1] 卢雨松 Cheng Lei;Jin Jian;Hu Jingguo;Lu Yusong(Affiliated Hospital of Chengdu University,Chengdu 610081,Sichuan Province,China)

机构地区：[1]成都大学附属医院

出　　处：《中国组织工程研究》2020年第16期2567-2571,共5页Chinese Journal of Tissue Engineering Research

基　　金：四川省卫生厅课题(120577)，课题名称：乌司他丁对胸部撞击伤后急性肺损伤抗炎因子变化的研究，项目负责人：金健;2018年成都市卫计委课题(2018061)，课题名称：聚左旋乳酸肋骨钉与纯钛环抱器在活体组织内生物学特性的对照研究，项目负责人：金健~~

摘　　要：背景:目前胸外科肋骨骨折的内固定材料包括聚乳酸肋骨钉、纯钛环抱器,关于两者的临床对照研究较多,但其在体内的分子炎性反应缺乏相关报道。目的:对比聚乳酸肋骨钉和纯钛环抱器植入兔体内后的炎性反应。方法:将16只新西兰大白兔(成都达硕公司提供)分为实验组和对照组,实验组右侧胸大肌植入聚乳酸肋骨钉,对照组右侧胸大肌植入纯钛肋骨环抱器,植入后3d、1周、2周、1个月、3个月抽取股动脉血,ELISA法检测白细胞介素1、白细胞介素6、乳酸与肿瘤坏死因子α浓度。取新西兰大白兔3只,左侧胸大肌植入聚左旋乳酸肋骨钉,右侧胸大肌植入纯钛肋骨环抱器,植入后1周、1个月、3个取包裹植入物周围肌肉组织,进行病理组织学观察。实验方案经成都大学附属医院伦理委员会批准。结果与结论:①植入后3 d、1周、2周、1个月、3个月,两组间白细胞介素1、白细胞介素6、乳酸与肿瘤坏死因子α浓度比较差异均无显著性意义(P>0.05);②植入后1周,环抱器组的主要病理变化为肌纤维坏死、炎细胞浸润、纤维组织增生,肋骨钉组主要病理变化为肌纤维坏死、炎细胞浸润和纤维组织增生,肌纤维坏死程度轻于环抱器组;植入后1个月,两组肌纤维坏死区域炎细胞数量均有所减少,坏死区域基本被纤维组织增生取代,其中肋骨钉组肌肉组织形态较为完整,组织损伤面积较小;植入后3个月,两组肌肉形态基本正常,只有少量炎细胞浸润;③结果表明,聚乳酸肋骨钉与纯钛环抱器在兔体内的炎性反应相当,无明显差异,并且聚乳酸肋骨钉植入后未增加兔体内的乳酸浓度。BACKGROUND: At present, the internal fixation materials for rib fractures in thoracic surgery include polylactic acid rib nails and pure titanium embracing devices. There are many clinical control studies on them, but there is no report on the molecular inflammatory response in vivo. OBJECTIVE: To investigate the inflammatory response of polylactic acid rib nails versus pure titanium embracing fixators in rabbits. METHODS: Sixteen New Zealand white rabbits(provided by Chengdu Dashuo Co., Ltd.) were divided into experimental group and control group. The right pectoralis major muscle of rabbits in the rib nail group was implanted with polylactic acid r ib nails, and the right pectoralis major muscle of rabbits in the embracing fixator group was implanted with pure titanium embracing fixator. Femoral arterial blood was collected 3 days, 1 week, 2 weeks, 1 month, and 3 months after implantation. The concentrations of interleukin 1, interleukin-6, lactic acid and tumor necrosis factor alpha were detected by ELISA method. Three New Zealand white rabbits were taken, and the left pectoralis major muscle was implanted with poly-L-lactic acid rib nail, and the right pectoralis major muscle was implanted with pure titanium rib embracing device. At 1 week and 1 month, three grafted implants were implanted. Peripheral muscle tissue was observed for histopathology. This study was approved by the Medical Ethics Committee of Affiliated Hospital of Chengdu University. RESULTS AND CONCLUSION:(1) There were no significant differences in the concentrations of interleukin-1, interleukin-6, lactic acid and tumor necrosis factor-α between the two groups at 3 days, 1 week, 2 weeks, 1 month, and 3 months after implantation(P > 0.05).(2) At 1 week, the main pathological changes were necrosis of muscle fibers, infiltration of inflammatory cells and hyperplasia of fibrous tissue in the embracing fixator group, and necrosis of muscle fibers, infiltration of inflammatory cells and hyperplasia of fibrous tissue in the rib nail group. The necr

关 键 词：聚乳酸肋骨钉 纯钛环抱器 炎性反应 动物实验 对照研究 组织相容性 白细胞介素1 肿瘤坏死因子α 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]