载骨形成蛋白2和肌肤生对兔胫骨慢性骨髓炎修复作用的实验研究  

Efficacy of apolipoprotein 2-Jifusheng in the treatment of osteomyelitis in rabbits

作　　者：蓝益南 李健[1] 蔡晓斌[1] 吴凌峰[1] 张扬[2] 吴件姿[1] LAN Yi-nan;LI Jian;CAI Xiao-bin;WU Ling-feng;ZHANG Yang;WU Jian-zi(Department of Orthopaedics Surgery,Lishui Central Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]浙江省丽水市中心医院骨科,浙江丽水323000 [2]浙江省中医药研究院,浙江杭州320012

出　　处：《中国骨伤》2021年第10期971-977,共7页China Journal of Orthopaedics and Traumatology

基　　金：浙江省医药卫生科技计划项目(编号:2018KY186);浙江省科技计划项目(编号:2017C37181)。

摘　　要：目的:探讨在骨髓炎兔的实验模型中,载骨形成蛋白2联合肌肤生一期治疗的效果评价。方法:选取3月龄雄性新西兰大白兔30只,体重(2.0±0.5)kg,制备兔胫骨慢性骨髓炎模型,并于术后4周进行模型验证。将30只兔慢性骨髓炎随机分为3组,每组10只。模型组于病灶清除后不做任何处理;治疗组A于病灶清除及骨缺损处植入肌肤生;治疗组B于病灶清除及骨缺损处植入载骨形成蛋白2-肌肤生。术后8周通过血液生化、微生物、影像学、病理学及免疫组化等检查进行治疗作用评价。结果:造模术后4周,30只骨髓炎兔模型验证成功,其中血清学检查结果显示,造模术后2周及4周模型组的超敏C反应蛋白显著高于空白组(P<0.01、P<0.05),白细胞计数显著高于空白组(P<0.05、P<0.01)。治疗术后8周,血液指标检测,治疗A组与治疗B组的白细胞计数、超敏C反应蛋白显著低于模型组(P<0.05),但治疗A与治疗B组差异无统计学意义。治疗术后8周,骨缺损面积测量,治疗A组与治疗B组的骨体积/总体积(BV/TV)及骨矿化密度大于模型组(P<0.05),且治疗B组的骨体积/总体积(BV/TV)及骨矿化密度大于治疗A组(P<0.05),骨缺损修复接近完全,骨体积与骨密度显著升高。治疗术后8周,骨组织病理学检测,治疗A组与治疗B组的HE染色指标成骨细胞数/骨组织面积(N.Ob/T.Ar)、成骨细胞数/骨组织周长(N.Ob/B.Pm)高于模型组(P<0.05),且治疗B组的N.Ob/T.Ar和N.Ob/B.Pm大于治疗A组(P<0.05);治疗A组与治疗B组的骨组织周围TNF-α和IL-6免疫组化阳性染色率少于模型组(P<0.05),但治疗组B与治疗组A差异无统计学意义。结论:载骨形成蛋白2-肌肤生联合应用能共同促进骨修复,并减轻病灶部位炎症,可以一期治疗兔慢性骨髓炎,为骨髓炎临床治疗策略制订提供客观依据,进一步促进临床研究。Objective:To evaluate the effect of one-stage treatment of bone morphogenetic protein 2 combined with Jifusheng in the experimental model of osteomyelitis in rabbits.Methods:The model of chronic osteomyelitis of tibia was established in 303-month-old male New Zealand white rabbits with a body weight of(2.0±0.5)kg,and the model was verified 4 weeks after operation.Thirty rabbits with osteomyelitis were randomly divided into 3 groups with 10 rabbits in each group(n=10).The model group did not do any treatment after focal debridement,treatment group A was implanted with musculosheng at the site of focal debridement and bone defect,and treatment group B was implanted with apolipoprotein 2-Jifusheng at the site of focal debridement and bone defect.The therapeutic effect was evaluated by blood biochemical,microbiological,imaging,pathological and immunohistochemical examination 8 weeks after operation.Results:At 4 weeks after operation,30 rabbits with osteomyelitis were successfully validated.The results of serological examination showed that the hypersensitive C-reactive protein(CRP)and white blood cell count(WBC)in the model group were significantly higher than those in the blank group at 2 and 4 weeks after operation.Eight weeks after treatment,the detection of blood indexes showed that the white blood cell count(WBC)and hypersensitive C-reactive protein(CRP)in treatment group A and treatment group B were significantly lower than those in the model group(P<0.05),but there was no significant difference between treatment group An and treatment group B(P>0.05).Eight weeks after treatment,the bone defect area was measured.The bone volume/total volume(BV/TV)and bone mineral density(BMD)in treatment group A and B were significantly higher than those in the model group(P<0.05),and the bone volume/total volume(BV/TV)and bone mineral density(BMD)in treatment group B were significantly higher than those in treatment group A(P<0.05),the repair of bone defect was almost complete,and the bone volume and bone mineral density incr

关 键 词：肌肤生 载骨形成蛋白2 骨髓炎 兔 骨修复 

分 类 号：R681[医药卫生—骨科学]