经皮注射外源性BMP和DCN治疗骨不连的实验研究

Empirical study of percutaneous injected exogenous BMP and DCN for the treatment bone nonunion

目的经皮注射外源性骨形态发生蛋白(BMP)和核心蛋白多糖(DCN),观察单独应用和联合应用两种因子治疗骨不连的效果。方法选10只新西兰大白兔,制作骨不连动物模型,将10只兔的20条桡骨随机分成4组,具体分组情况如下:1)BMP-2组;2)BMP-2+DCN组;3)DCN组;4)空白组。通过影像学、生物力学及组织学检测比较骨不连接区的成骨效果。结果X线检查骨不连区有骨吸收、断端硬化、髓腔封闭及少量不规则骨痂。外源性注射成骨因子4周后,镜下观察BMP-2+DCN组的骨不连接区组织成骨较其他3组明显。影像学观察注射BMP-2组和BMP-2+DCN组肢体骨折区成骨量明显增多,DCN组和空白组则较少。生物力学检测,空白组与DCN组的压缩刚度及最大负荷无显著差异,但均低于BMP-2组与BMP-2+DCN组;BMP-2+DCN组的刚度与最大负荷均明显优于其他3组(P<0.05)。结论BMP-2复合纤维蛋白胶具有较好的骨诱导作用,可作为BMP -2理想的载体之一。骨不连接区联合应用BMP和DCN局部注射治疗较单独应用BMP的效果明显,能促进骨不连接区陈旧性组织成骨,单独使用DCN效果不明显。

Objective To compare the differential effects of bone morphogenetic protein(BMP) and decorin (DCN) percutaneously injected alone or combined in bone nonunion model.Methods Ten New Zealand white rabbits selected were made into bone nonunion models,and divided into four groups:BMP-2 groups,BMP-2 and DCN groups, DCN groups and control groups.Through imaging,biomechanical test and histological detection,compar the osteogenic effect in the area of bone nonunion after the injection of BMP and DCN combined with Adoption Fibrin sealant.Results X-ray examination show bone resorption,broken ends sclerosis,cavum medullare blockage,and osteotylus formation in the area of bone nonunion.After injection exogenous factors,BMP-2 and DCN group bone mass increased significantly than the other three groups under the microscope.By imaging,bone formated greatly in BMP-2 group and BMP-2,DCN combined group while DCN group and the control group it is less.Bioniechanical testing show the compression stiffness and maximum load difference in the control group and DCN group was not significant,but were lower than the BMP-2 group and BMP-2,DCN combined group;the stiffness and the largest load in BMP-2,DCN combined group were significantly better than the other three groups,there were significant differences(P<0.05) Conclusion BMP-2 composite fibrin glue has good bone induction effects,can serve as an ideal carrier.Combined BMP and DCN local injection in the area of bone nonunion can get more obviously effects than BMP alone,and promote old organization to ossify.