抗感染重组合异种骨系列实验研究  

Experimental study of anti-infective reconstructed bone xenograft

作　　者：袁志[1] 胡蕴玉[1] 孙梁[1] 刘建[1] 雷伟[1] 王彦清[2] 孙怡群[3] 夏洁来[4] 

机构地区：[1]第四军医大学西京医院全军骨科研究所,西安710032 [2]第四军医大学西京医院影像科,西安710032 [3]第四军医大学西京医院检验科细菌室,西安710032 [4]第四军医大学西京医院统计教研室,西安710032

出　　处：《中华医学杂志》2003年第2期128-132,共5页National Medical Journal of China

基　　金：全军"九五"指令性课题基金资助 ( 96L0 5 2 )

摘　　要：目的　研制和开发能Ⅰ期植骨、有效修复污染性或感染性骨缺损的植骨材料。方法在重组合异种骨 (RBX)的基础上 ,结合抗生素局部缓释技术 ,研制抗感染重组合异种骨 (ARBX) ,并通过小鼠股部肌袋模型检测其诱导成骨活性和抗生素释放特性 ;将其Ⅰ期植入细菌污染的犬桡骨骨缺损和已感染的兔胫骨骨缺损中 ,通过放射学、组织学、细菌学检测手段 ,评价其对污染性或感染性骨缺损的修复效果 ,以及对骨髓炎的防治作用。结果　 ( 1)ARBX既保持高效诱导成骨活性 ,又有较好的抗生素缓释作用 ,在局部可维持长达 30d的有效抗菌浓度 ,因此具有显著增强的抗感染能力 ;( 2 )ARBX在彻底清创基础上 ,可Ⅰ期植骨修复细菌污染的犬桡骨骨缺损 ,并有效预防骨髓炎发生 ;( 3)在彻底病灶清除前提下 ,ARBX可Ⅰ期植骨修复已感染的兔胫骨骨缺损 ,并能有效治疗慢性骨髓炎。结论　ARBX具有高效诱导成骨活性和强力抗感染能力 ,能Ⅰ期植骨修复污染或感染的骨缺损 ,并可有效防治骨髓炎。为ARBX应用临床 ,解决污染或感染骨缺损治疗上的难题 ,提供较好的实验基础。Objective To develop a new type bone graft material that can be used as primary graft in contaminated even infected bone defect. Methods Anti-infective reconstructed bone xenograft (ARBX) was developed by combining reconstructed bone xenograft (RBX) with gentamycin and gelatin. One piece of ARBX was implanted in the muscle pouch in right thighs of 32 mice. The implanted ARBX and surrounding soft tissues were taken out from the mice at different time point to make into homogenate and the concentration of released gentamycin in the supernatant and the diameter of the bacterial inhibition ring of each specimen were tested. One piece of ARBX was implanted into the muscle pouch at the right thigh of 16 mice and one piece of RBX was implanted into the muscle pouch at the right thigh of another 16 mice. Fourteen days after the grafts and surrounding tissues were taken out to be examined histologically or made into homogenate to test the alkaline phophatase (ALP) activity. Bone defect was made in the bilateral radii and then Staphylococcus aureus was injected and debridement was conducted. 10 pieces of ARBX were implanted into the bone defect at the left radius and 10 pieces of RBX were implanted into the bone defect at the right radius. The defect was then fixed and the wound was sutured. Gentamycin was injected for 1 week. Six months later X ray examination was conducted to the radius, then the radius was taken and half of specimens were examined histologically and half of them was made into homogenate to examine the amount of Staphylococcus aureus. Defect was made in the right tibia of 25 rabbits and Staphylococcus aureus injected therein. Then the rabbits were divided into 5 groups of 5 individuals: group 1 (3 pieces of ARBX were implanted), group 2 (3 pieces of RBX were implanted and gentamycin was used locally), group 4 (3 pieces of RBX were implanted and gentamycin was injected intramuscularly), and group 5 (control group, without born grafting). Eight weeks after, radiological, histological, and bacteriologica

关 键 词：抗感染重组合异种骨 实验研究 庆大霉素 骨移植 骨疾病 

分 类 号：R687[医药卫生—骨科学]