肩袖腱骨愈合中组织工程学再生的机制及问题  

Regeneration mechanism and problems of tissue engineering in rotator cuff tendon-bone healing

作　　者：王旭[1,2] 杨腾云 熊波涵 张瑶璋 卢晓君 龙丹 赵道洪[1,2] Wang Xu;Yang Tengyun;Xiong Bohan;Zhang Yaozhang;Lu Xiaojun;Long Dan;Zhao Daohong(Department of Orthopedics,The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,Yunnan Province,China;Kunming Medical University,Kunming 650500,Yunnan Province,China;Department of Sports Medicine,The First Affiliated Hospital of Kunming Medical University,Kunming 650000,Yunnan Province,China)

机构地区：[1]昆明医科大学第二附属医院骨科,云南省昆明市650000 [2]昆明医科大学,云南省昆明市650500 [3]昆明医科大学第一附属医院运动医学科,云南省昆明市650000

出　　处：《中国组织工程研究》2023年第18期2928-2934,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81960412),项目负责人:赵道洪;云南省科技厅-昆明医科大学基础研究联合专项[2019FE001(-065)],项目负责人:赵道洪。

摘　　要：背景:近年来关节镜下进行肩袖修补术已经成为临床治疗肩袖损伤的“金标准”,但经肩袖修补术治疗后的术后再撕裂率却居高不下,其主要原因在于肩袖原有结构无法恢复,因此仅通过手术方法进行解剖学愈合是远远不够的。随着组织工程学的发展,越来越多的学者发现其对肩袖愈合有着巨大的优势,可以有助于激发腱骨界面有序再生,随着研究的不断深入,各类支架、种子细胞、生长因子层出不穷,具有广阔前景。但目前国内外相关综述较少,不便临床医生及相关领域学者总体了解研究近况。目的:对近年来肩袖腱骨愈合领域研究中的组织工程学相关支架材料、种子细胞及细胞因子做一总结,以期对肩袖腱骨愈合的基础研究和临床进展起到一定的启示作用。方法:通过计算机检索中国知网及PubMed数据库,中、英文检索词为“肩袖损伤,组织工程;rotator cuff,tissue engineering”等。对检索出的10年内文献进行筛选,排除与文题无关及质量低或重复文献,并手动纳入其他相关文献,最终对纳入的69篇文献进行结果分析。结果与结论:组织工程在腱骨结合部位的再生领域中有着巨大的潜力。(1)目前的支架材料可大体分为天然材料支架、人工合成材料支架及复合材料支架3种类型,其各有优势,但复合材料支架似乎可以更好地仿生腱骨界面原有的梯度结构因此具备更大前景。(2)各类干细胞和生物因子的搭载也被证实可以激发损伤区域的修复潜能。然而干细胞种类的选择和各类生物因子内在分子信号通路的研究仍需进一步深入,进而明确具体的生物因子的介入时间节点及层次,达到精准诱导原有4层结构再生的目的。BACKGROUND:In recent years,arthroscopic rotator cuff repair has become the“gold standard”of clinical treatment.However,the rate of postoperative retears after rotator cuff repair remains high,mainly because the original rotator cuff structure cannot be restored.Therefore,anatomical healing through surgery alone is not sufficient.With the development of tissue engineering,more and more scholars have found that it has great advantages for rotator cuff healing and can help stimulate the orderly regeneration of the tendon bone interface.As scholars continue to go deeper and deeper,various types of scaffolds,seed cells,and growth factors have emerged,which have great prospects.However,there are few related reviews at the domestic and international levels,which makes it inconvenient for clinicians and scholars in related fields to understand the recent status of research in general.OBJECTIVE:To provide a summary of recent research on scaffold materials,seed cells,and cytokines related to tissue engineering in the field of rotator cuff tendon bone healing,with the aim of shedding light on basic research and clinical progress in rotator cuff tendon bone healing.METHODS:The search terms“rotator cuff injury,tissue engineering”were searched in English and Chinese by computer in PubMed and CNKI databases.The literature retrieved within 10 years was screened to exclude irrelevant,low quality or duplicate literature,and other relevant literature was included manually.Eventually,69 papers were included for result analysis.RESULTS AND CONCLUSION:Tissue engineering has a great potential in the field of regeneration of tendon-bone union sites.(1)Current scaffold materials can be broadly classified into three types(natural material scaffold,synthetic material scaffold,and composite material scaffold),each with its own advantages.However,composite scaffolds seem to be more promising as they can better mimic the original gradient structure of the tendon-bone interface.(2)The pigmentation of various types of stem cells and bio

关 键 词：肩袖损伤 腱骨愈合 组织工程 支架 干细胞 综述 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687.4