自体组织工程生长板治疗长骨生长板损伤的实验研究  

Autograft growth plate to treat growth plate damage of long bone: An experimental study

作　　者：罗卓荆[1] 靳小兵[1] 杨柳[1] 兰丽锋[1] 

机构地区：[1]西安第四军医大学西京医院全军骨科研究所,710032

出　　处：《中华小儿外科杂志》2003年第6期537-540,共4页Chinese Journal of Pediatric Surgery

基　　金：国家教育部高等院校骨干教师资助

摘　　要：目的 探讨自体组织工程生长板在治疗生长板损伤中的作用。方法 自3周龄兔骼嵴处切取部分骼骨生长板软骨经机械剪切和Ⅱ型胶原酶消化后培养生长板软骨细胞,体外扩增后接种到同种异体脱钙骨基质(DHM)上,混合培养一周后,植入兔自体右侧胫骨上端内侧生长板缺损处(A组),分别设单纯DBM植入(B组)及单纯破坏即生长板破坏后无任何植入物(C组)作为对照组,左侧胫骨不作处理。术后动态X线摄片测量下肢短缩及成角畸形改变,通过组织切片HE染色及Ⅱ型胶原免疫组化染色观察自体组织工程生长板在体内的转归。结果 术后第2周三组右侧胫骨均出现轻度畸形,A、B组较C组为轻,但三者之间无显著差异(P>0.05),此后B、C组兔右侧胫骨出现渐进性严重短缩及成角畸形,而A组右侧胫骨畸形则无明显加重,各时间点A组胫骨成角及缩短畸形与B、C组有显著差异(P<0.05),术后第16周时组织切片显示,A组损伤区基本恢复正常生长板结构,Ⅱ型胶原免疫组化染色阳性,而B、C组损伤区则由新生骨组织修复。结论 自体组织工程生长板植入可有效防止急性生长板损伤后肢体畸形的发生,植入的组织工程生长板可产生柱状排列的结构,细胞可表达Ⅱ型胶原。Objective To observe the role of autografting growth plate tissue-engineering for growth plate injuries of long bone. Methods The growth plate cartilage from iliac crest of New Zealand rabbits (age,3-week) was dissected and sequential digested with 0.2% collagenase (type Ⅱ). After proliferate with monolayer culture in vitro for three weeks, the cells were harvested and seeded into DBM to form the tissue-engineered growth plate. The experiments were divided into three groups: (1) group A, the auto- graft growth plate was implanted into the medial proximal defects of growth plate of right tibia of the rab- bit; (2) group B, DBM were implanted into the defects and (3) control group, growth plate damaged with- out any implantation. The shortening and angulation deformity of the tibia was evaluated by X-ray film postoperatively. The histologic changes were observed by HE staining under light microscopy and the colla- gen Ⅱ secretion was analyzed by immunohistochemical staining. Results The mild deformity was observed on all three groups in two weeks but without significant difference (P>0.05). The severe shortening and angulation deformity of the right tibia were observed on group B and C after two weeks. There were signifi- cant difference of shortening and angulation deformity among group A, B and C in the duration of 4, 8, 16 weeks. The growth plate defects of group A were recovered near to the normal structure with positive type Ⅱ collagen 16th week postoperatively. While the tibial growth plate defects of group B and C were filled with newly formed bone. Conclusion The autograft growth plate implantation can prevent the extremity deformity formation and promote restoration to the damaged growth plate.

关 键 词：自体组织工程生长板 治疗 长骨生长板损伤 实验研究 细胞培养 

分 类 号：R687[医药卫生—骨科学]