富血小板血浆及浓缩生长因子和微纳米3D复合支架修复兔桡骨缺损的比较  

Comparison of platelet-rich plasma,concentrated growth factor and 3D micro-nanostructure composite scaffolds in repair of rabbit radius defects

作　　者：冯俊铭 熊贤梅 马立琼 张严 陈梓杰 李世杰[1] 陈柏行 姜自伟[1,2] 曾展鹏[1,2] 高怡加[1,2] Feng Junming;Xiong Xianmei;Ma Liqiong;Zhang Yan;Chen Zijie;Li Shijie;Chen Baixing;Jiang Ziwei;Zeng Zhanpeng;Gao Yijia(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;First Department of Orthopedics,First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,广东省广州市510405 [2]广州中医药大学第一附属医院一骨科,广东省广州市510405

出　　处：《中国组织工程研究》2023年第12期1906-1913,共8页Chinese Journal of Tissue Engineering Research

基　　金：广东省自然科学基金项目(2018A030313369),项目负责人:高怡加。

摘　　要：背景:近年来,富血小板血浆、浓缩生长因子和3D打印的纳米级羟基磷灰石支架成为骨移植的热门研究材料,目前这些材料的研究方向较分散,现有研究中鲜有针对大段骨缺损的治疗且缺乏不同类型材料的比较,因长骨干的主要成分为皮质骨,其愈合更具挑战。目的:通过实验评估和比较富血小板血浆、浓缩生长因子和微纳米3D复合支架对骨缺损愈合的影响。方法:纳入32只新西兰大白兔,制备桡骨15 mm骨缺损模型,根据不同移植物随机分为4组:空白组(不做处理)、富血小板血浆组(富血小板血浆)、浓缩生长因子组(浓缩生长因子)和3D复合支架组(微纳米3D复合支架),每组8只。术后第1天及第6,12周行X射线检查,在术后12周先行行为学观察,之后取兔尺桡骨标本行Micro CT扫描,对比骨密度和骨体积分数,最后将骨标本切片后显微镜下观察。结果与结论:①富血小板血浆组、浓缩生长因子组和3D复合支架组均有不同程度的新骨形成,行为学观察差异较小;而空白组基本无新骨形成,术后12周均出现明显的跛行;②在术后6,12周的X射线成像上各干预组要优于空白组,而各干预组之间对比灰度值差异也较明显,但富血小板血浆组和浓缩生长因子组在12周未见明显差异;③术后12周富血小板血浆组和浓缩生长因子组在骨密度和骨量对比上无显著差异,但各参数均优于3D复合支架组;④提示富血小板血浆和浓缩生长因子无疑能促进早期新骨形成,且两者在长远影响中无明显差异;由羟基磷灰石制作的无机材料支架难以完全促进骨缺损愈合,需加入其他有机成分改善其性能才能发挥最大的成骨效能。BACKGROUND:In recent years,platelet-rich plasma,concentrated growth factors,and 3D-printed nanoscale hydroxyapatite scaffolds have become popular research materials for bone transplantation.At present,the research directions of these materials are scattered,and there are few existing studies targeting large segments of bone and lack of comparison of different types of materials.Because the main component of long diaphysis is cortical bone,its healing is challenging.OBJECTIVE:To evaluate and compare the effects of platelet-rich plasma,concentrated growth factor,and 3D micro-nanostructure composite scaffold on bone defect healing.METHODS:Thirty-two New Zealand white rabbits were enrolled to prepare radial bone defect model of 15 mm.According to the graft,they were divided into four groups(n=8):blank group(no treatment),platelet-rich plasma group(platelet-rich plasma),concentrated growth factor group(concentrated growth factor)and 3D composite scaffold group(3D micro-nanostructure composite scaffold).X-ray examination was performed at 1 day,6 and 12 weeks postoperatively.Behavioral observation was performed at 12 weeks postoperatively.The rabbit ulnar and radial bone specimens were taken for Micro CT scanning to compare bone mineral density and bone volume fraction.Finally,the bone specimens were sliced and observed under a microscope.RESULTS AND CONCLUSION:(1)The platelet-rich plasma,concentrated growth factor,and 3D composite scaffold groups had different volumes of new bone with little behavioral difference,while the blank group had almost no new bone formation and obvious claudication occurred at 12 weeks after operation.(2)X-ray imaging was better in each intervention group than that in the blank group at 6 and 12 weeks after surgery.The difference in gray values was obvious between the intervention groups,but there was no significant difference between platelet-rich plasma and concentrated growth factor groups at 12 weeks.(3)At 12 weeks after surgery,there was no statistically significant difference in bone mi

关 键 词：骨缺损 富血小板血浆 浓缩生长因子 羟基磷灰石 复合支架 桡骨 骨愈合 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681