组织工程技术在股骨头坏死治疗中的应用及前景  

Application and prospect of tissue engineering in treatment of osteonecrosis of the femoral head

作　　者：陈凯佳 刘景云 曹宁[2] 孙建波[2] 周燕[3] 梅建国 任强[1,2] Chen Kaijia;Liu Jingyun;Cao Ning;Sun Jianbo;Zhou Yan;Mei Jianguo;Ren Qiang(Department of Bone Joint,Binzhou Medical University Hospital,Binzhou 256600,Shandong Province,China;School of Materials and Engineering,China University of Petroleum(East China),Qingdao 266580,Shandong Province,China;East China University of Science and Technology,Shanghai 200237,China;Shandong Binzhou Animal Science&Veterinary Medicine Academy,Binzhou 256600,Shandong Province,China)

机构地区：[1]滨州医学院附属医院骨关节外科,山东省滨州市256600 [2]中国石油大学(华东)材料与工程学院,山东省青岛市266580 [3]华东理工大学,上海市200237 [4]山东滨州畜牧兽医研究所,山东省滨州市256600

出　　处：《中国组织工程研究》2024年第9期1450-1456,共7页Chinese Journal of Tissue Engineering Research

基　　金：山东省医药卫生科技发展计划项目(2017WS040),项目负责人:任强;2020年产学合作协同育人项目(202002204024),项目负责人:任强;滨州医学院徐荣祥再生医学发展计划项目(BY2019XRX04),项目负责人:任强。

摘　　要：背景:股骨头坏死早期多采用植骨类保髋手术治疗,其中自体骨与异体骨是常用的植骨材料,但自体骨移植创伤性大且供骨来源有限,异体骨虽来源丰富,但存在严重的免疫排斥反应和吸收风险。近年来,以间充质干细胞为基础的组织工程技术是治疗股骨头坏死的新方法,经过基础实验和临床应用的检验,正逐渐得到广泛应用。目的:综述组织工程技术在股骨头坏死治疗中的应用及前景,为临床治疗股骨头坏死提供新的选择。方法:由第一作者检索2013-2023年的PubMed数据库和中国知网,英文检索词为“tissue engineering,mesenchymal stem cells,biological scaffolds,cytokines,osteonecrosis of the femoral head,bone graft,hip preservation”,中文检索词为“组织工程,间充质干细胞,生物支架,细胞因子,股骨头坏死,植骨,保髋”,选择运用组织工程技术治疗股骨头坏死方面的文献,根据纳入与排除标准对所有文章进行初筛后,共纳入55篇代表性文献进行综述。结果与结论:①随着生物技术与材料学的不断发展,骨组织工程技术治疗股骨头坏死己取得较大进展,例如基因修饰的间充质干细胞修复骨坏死、基因重组技术及表面改性技术与骨组织工程的结合在股骨头坏死治疗中的应用等;②组织工程技术应用于坏死股骨头时可促进坏死骨组织再生和血管系统的修复,同时为坏死区域提供生物力学稳定性,并且利用生物活性因子促进种子细胞的修复作用,完成坏死区新生骨的再生;③但目前这些研究大多数尚处于动物实验阶段,骨组织工程研究仍存在许多未解决的问题和挑战,随着纳米技术、组织工程学和临床医学的快速发展,性能完善的仿生替代植骨材料将有望诞生;④在未来应用骨组织工程技术治疗股骨头坏死有望成为一种令人满意的治疗方式,给保髋患者带来福音。BACKGROUND:Osteonecrosis of the femoral head is a common orthopedic disease,and hip preservation surgery with bone grafting is commonly used in the early stage,in which autologous bone and allograft bone are commonly used as bone grafting materials.However,autologous bone transplantation is highly traumatic and bone supply is limited,and allograft bone is rich in sources,but there are serious risks of immune rejection and absorption.In recent years,the tissue engineering technique based on mesenchymal stem cells is a new method for the treatment of femoral head necrosis,which is gradually widely used after basic experiments and clinical application.OBJECTIVE:To review the application and prospect of tissue engineering in the treatment of osteonecrosis of the femoral head to provide a new choice for the clinical treatment of osteonecrosis of the femoral head.METHODS:The PubMed database and CNKI database from 2013 to 2023 were searched by the first author with Chinese and English search terms“tissue engineering,mesenchymal stem cells,biological scaffolds,cytokines,osteonecrosis of the femoral head,bone graft,hip preservation”.The articles on the treatment of osteonecrosis of the femoral head with tissue engineering technology were selected,and 55 representative articles were included for review after the initial screening of all articles according to the inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)With the continuous development of biotechnology and materials science,great progress has been made in the treatment of osteonecrosis of the femoral head by bone tissue engineering,such as the application of gene-modified mesenchymal stem cells to repair osteonecrosis,the combination of gene recombination technology and surface modification technology with bone tissue engineering in the treatment of osteonecrosis of the femoral head.(2)When applied to the necrotic femoral head,tissue engineering technology can promote the regeneration of necrotic bone tissue and the repair of the vascular system,provide

关 键 词：组织工程 间充质干细胞 生物支架 细胞因子 股骨头坏死 植骨 保髋 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R684.2