胶原膜对引导性骨再生影响的实验观察

Experimental Study on Guided Bone Regeneration with Collagen Membrane

目的:观察降解材料隔膜对引导性骨再生的影响,探讨其作用机制。方法:以新西兰兔为研究对象,采用胶原隔膜.制做桡骨引导性骨于再生模型。术后分别进行X线观察、组织学观察以及bFGF、TGF-β、BMP免疫组化染色,并对3种骨诱导因子的含量进行测量。结果:术后1周时胶原隔膜即在骨缺损处形成密闭的管状腔室,术后6～8周降解,降解后仍有骨痂形成。12周时胶原隔膜能够引导骨再生修复骨缺损。术后6周内实验侧bFGF、TGF-β、BMP总体含量明显高于对照侧(P<0.001)。结论:术后6周内胶原隔膜在骨缺损处形成密闭腔室,将周围组织隔离于骨缺损之外,提供骨再生的空间,并将骨缺损处骨诱导因子浓缩,成功诱导骨组织再生;6～8周后胶原隔膜降解不影响骨再生过程。结果表明引导性骨再生早期的骨形成具有重要的作用,引导性骨再生启动后,即使8周隔膜降解,仍不影响骨缺损修复。

The guided bone regeneration (GBR) with biodegradable membrane in long bone was studied in order to clarity the role of biodegradable membrane in GBR. Methods: New Zealand rabbits were used to established GBP model with collagen membrane. The X-ray and histological examination of callus, and immunohistochemical staining of BMP, TGF-β, bFGF were observed, and the content of 3 osteoinductors were measured in different time postoperatively. Results: The sealed bone chambers were formed by collagen membrane tubes, which degraded within 6 or 8 weeks, after that callus was going on forming. The bone defects were repaired by GBR with collagen membranes at 12 week after operation. The whole content of BMP, TGF-β, bFGF in the test sides was much more than that in control sides( P<0. 001) . Conclusion: The sealed bone chambers were formed by collagen membranes within 6 weeks postoperatively, which separated the around tissue from the bone defects and provided space for bone regeneration and concentrated osteoinductors for successful inducing boric regeneration. Callus forming was not affected by degradation of collagen membrane in 6 or 8 weeks postoperatively. The results indicated that the early callus played a very important role in GBR, when GBR was initiated, bone defects would be repaired in spite of degradation of collagen membrane in 8 weeks.