摘要
背景:骨缺损临床常用治疗方法有自体骨移植、异体骨移植和人工骨移植,但都存在不同程度的缺点。因此,如何更好的修复缺损的骨组织,成为外科领域关注的热点。目的:制备磷酸钙人工骨与骨髓基质干细胞复合物,通过动物实验观察骨缺损的修复作用。设计:随机对照实验单位:青岛大学医学院附属医院创伤外科。材料:实验于2002-05/2003-09在青岛大学医学院附属医院动物实验中心进行。新西兰健康成年大白兔24只,6～14个月龄,体质量9～3.5kg,雌雄不限。方法:①分离、扩增兔骨髓基质干细胞,并以磷酸钙人工骨为载体制备磷酸钙人工骨与骨髓基质干细胞复合物。②24只兔(48侧)制作成骨缺损模型,分为3组,复合物组(24侧),24只兔一侧骨缺损植入细胞+载体复合物;人工骨组(12侧),12只兔对侧植入磷酸钙人工骨;空白对照组(12侧),12只兔对侧骨缺损不作任何处理。术后8,16,24周,每组每个时间点取4只动物进行放射性核素监测,并分别于麻醉状态下处死相应动物,进行X射线摄片、组织学染色分析。主要观察指标:①各组动物骨缺损区大体观察。②X射线检查结果。③组织形态学观察结果。④放射性核素监测结果。结果:24只兔均进入结果分析。①各组动物骨缺损区大体观察及X射线检查结果:24周时,复合物组骨断端部分连结,新骨与材料之间的边界不清,未见到髓腔再通;单纯人工骨组植入材料与截骨断端融合,材料体积较植入初期变化不明显;空白对照组形成骨不连,髓腔封闭。②组织形态学观察结果:24周时,复合物组骨缺损范围变小,骨缺损处相连;人工骨组新骨与材料结合紧密并部分长入;空白对照组髓腔封闭,形成骨不连。③放射性核素监测结果:复合物组和人工骨组8～24周间肉眼可分辨出放射性浓度呈明显上升趋势。结论:磷酸钙人工骨与骨髓基质干细胞复合物可再生新骨组织并完好地修复桡骨缺损,且修复能力明显优于单纯的磷酸钙人工骨。
BACKGROUND： Bone defect is commonly treated in clinic with autograft, allograft and artificial bone graft, but with the disadvantages to various extents. Therefore, how to better repair bone tissue in bone defect becomes the hot spot in surgical field. OBJECTIVE： The complex of marrow stromal stem cell （MSC） and calcium-phosphates artificial bone （CPAB） was prepared and the repair of bone defect was observed in animal experiment.
DESIGN： Randomized controlled experiment was designed.
SETTING： Department of Traumatic Surgery, Affiliated Hospital of Qingdao University Medical College.
MATERIALS： The experiment was performed in Animal Experimental Center of Affiliated Hospital of Qingdao University Medical College from May 2002 to September 2003, in which, 24 New Zealand health normal big white adult rabbits were employed, aged varied from 6 to 14 months, mass weighted from 9 to 3.5 kg, of either sex.
METHODS： ① Rabbit MSCs were differentiated and proliferated and CPAB was taken as carrier to prepare the complex of CPAB and MSCs. ② 24 rabbits （48 laterals） were prepared as model of bone defect, divided into 3 groups, named complex group （24 laterals）, in which, unilateral bone defect of 24 rabbits were implanted with cell ＋ carrier complex; The artificial bone group （12 laterals）, in which, CPAB was implanted contralaterally; and blank control （12 laterals）, in which, no any management was done contralaterally in bone defect of 12 rabbits. In 8, 16 and 24 weeks after surgery, 4 animals were collected at each time spot in each group for radionuclide monitoring; and the animals were sacrificed under anesthesia for X-ray picturing and histological staining analysis.
MAIN OUTCOME MEASURES： ① Gross observation of bone defect in each group. ② Results of X-ray examination. ③ Results of histomorpho- logic observation. ④ Results of radionuclide monitoring.
RESUILTS： 24 rabbits all entered result analysis. ① Gross observation of bone defect in each group and results of X-ray examination： In complex group of 24 hours, the fractured ends were connected partially, the bounder was not clear between the regenerated bone and material and reopened medullary cavity was not visible. In simple artificial bone group, the implanted material was integrated with the cross end and material volume did not change obviously compared with the initial implanting stage. In bland control, ununion fracture presented and medullary cavity was closed. ② Results of histomorphological observation： In 24 hours, the bone defect was smaller in size and the union happened on the defect area in complex group. In artificial bone group, the regenerated bone was integrated tightly with the material and grew inside partially. In blank control group, medullary cavity was closed and bones were not connected. ③ Results of radionuclide monitoring： It was remarkably distinguished with naked eye that radioactive concentration was in tendency of obvious increasing in both complex group and artificial bone group in 8-24 weeks.
CONCLUSION： The complex of CPAB and MSCs regenerates bone tissue and repair radial defect in whole. In addition, the repair ability is superior remarkably to simple CPAB.
出处
《中国临床康复》
CSCD
北大核心
2005年第46期140-142,F0003,共4页
Chinese Journal of Clinical Rehabilitation
