载抗结核药物人工骨在兔椎体结核模型中的应用研究  

Application of artificial bone bearing anti-tuberculosis drugs in rabbit vertebral tuberculosis model

作　　者：冯昊[1] 吴春秀[2] 石云志[1] FENG Hao;WU Chun-xiu;SHI Yun-zhi(Department of Orthopedics,Qinhuangdao Third Hospital,Qinhuangdao Hebei 066000,China;Department of Gynecology,Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第三医院骨科,河北秦皇岛066000 [2]秦皇岛市第一医院妇科,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2021年第20期2156-2160,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究课题计划项目(编号:20191741);河北省秦皇岛市科学技术局(编号:201902A132)。

摘　　要：目的探究载抗结核药物人工骨在兔椎体结核模型中的应用。方法选用60只新西兰大白兔,颈背根部皮下注射0.1 mL的弗兰氏佐剂致敏建立兔椎体结核模型,最终取造模成功的新西兰大白兔57只,采用随机数字表法分为A、B、C 3组,各19只。A组缺损区填入载异烟肼(INH)、利福平(RFP)纳米羟基磷灰石(nHA)-硫酸钙(CSH)-壳聚糖(CTS)人工骨;B组缺损区填入不载药人工骨;C组缺损区不作处理。比较置入药物24 h、72 h、1周、2周、4周、6周、8周、10周和12周时椎体和椎旁肌中INH和RFP浓度,比较置入药物24 h和72 h后3组的lane-sandhu评分和不同时刻各组的成骨影像图。结果病灶椎体及椎旁肌中INH释放平缓,无突释,药物置入后第8周浓度最低,不同时刻椎体内INH浓度均高于椎旁肌,差异均有统计学意义(P<0.05)。病灶椎体及椎旁肌中RFP释放处在突释现象,药物置入后第1周浓度最大,第8周椎旁肌内浓度最低,第12周椎体内浓度最低。药物置入后24 h和8w椎体内浓度高于椎旁肌,置入后1周、2周时药物浓度低于椎旁肌,差异均有统计学意义(P<0.05)。A组和B组置入药物24 h和72 h后的lane-sandhu评分均高于C组,差异均有统计学意义(P<0.05);但A组和B组各时刻的lane-sandhu评分比较均差异无统计学意义(P>0.05)。术后4周可见A组与B组植骨界面模糊,形成一定量不规则骨痂,C组骨痂较少,透明区明亮;术后8周可见A组与B组植骨面存在大量骨痂,形成椎间骨桥,骨缺损线模糊,C组植骨界面模糊,椎间骨桥形成差,骨缺损线扩大,原有外骨痂消失,透亮区明显。结论载INH、RFP nHA-CSH-CTS人工骨可持续、缓慢且长效的释放抗结核药物,促进骨再生,不会对成骨能力产生影响。Objective To explore the application of artificial bone loaded with anti-tuberculosis drugs in rabbit vertebra tuberculosis model.Methods Sixty New Zealand white rabbits were selected and subcutaneously injected with 0.1 mL of Flan's adjuvant to sensitize the base of the nape to establish a rabbit vertebral tuberculosis model.Finally,57 New Zealand white rabbits successfully modeled were randomly selected and divided into 3 by the random number table method.Group of 19 each.The defect area of group A was filled with artificial bone containing isoniazid(INH),rifampicin(RFP)nano-hydroxyapatite(nHA)-calcium sulfate(CSH)-chitosan(CTS).The defect area of group B was filled with non-loaded artificial bone.The defect area in group C was not treated.INH and RFP concentrations in vertebral bodies and paravertebral muscles at 24 h,72 h,1w,2w,4w,6w,8w,10w and 12w were compared.Lane-sandhu scores and osteogenic imaging images of each group at different times were compared after 24 h and 72 h of drug implantation.Results The release of INH in the focal vertebral body and paravertebral muscle was gentle without sudden release,and the concentration of INH in the vertebral body at the 8th week after drug implantation was the lowest,and the concentration of INH in the vertebral body at different moments was higher than that in the paravertebral muscle,the differences were statistically significant(P<0.05).RFP release occurred in the focal vertebral body and paravertebral muscle,and the concentration was the highest at the first week after drug implantation,the lowest in the paravertebral muscle at the eighth week,and the lowest in the vertebral body at the twelfth week.The concentration in the vertebrae at 24 h and 8w after implantation was higher than that in the paravertebral muscle,and the concentration at 1w and 2w after implantation was lower than that in the paravertebral muscle,the differences were statistically significant(P<0.05).The Lane-Sandhu scores of groups A and B after 24 h and 72 h of drug implantation were highe

关 键 词：兔椎体结核模型 人工骨 异烟肼 利福平 

分 类 号：R529.2[医药卫生—内科学] R-332[医药卫生—临床医学]