人骨膜细胞体外培养的实验研究与临床应用

Human autologous cultured and explanded periosteal cells transplantation for repair of distracted bone gaps:an experimental study and clinical application

目的 :研究体外培养的人骨膜细胞的形态学特征 ;探讨人骨膜细胞自体移植治疗骨不连及骨缺损的临床效果。方法 :常规细胞培养法行人骨膜细胞体外培养 ,观察其形态特征及超微结构 ;经皮注入体外培养的自体骨膜细胞治疗骨不连、骨缺损。结果 :人骨膜培养活细胞早期呈梭形 ,饱满透明 ,立体感强 ;分裂期呈立方形或短柱状 ;后期由长梭形逐渐变成宽梭和不规则形 ,分泌功能旺盛。电镜观察 :胞体呈梭形 ,膜面有少量微绒毛状突起 ,粗面内质网丰富 ,有大量异噬体等次级溶酶体 ,线粒体体积较小、基质致密有少量嵴。有原代细胞生物形态学特征。治疗骨不连、骨缺损 11处 ,治愈率为 73 % ;骨延迟愈合 4处 ,治愈率为 10 0 %。移植后均无明显全身和局部反应 ,12～ 16周达到骨性愈合。结论 :人骨膜成骨细胞可经体外培养大量增殖 ,且细胞传代进化后 ,其形态学结构与原代细胞无明显差异 ,可用于细胞移植。骨膜细胞移植能促进骨不连。

Objective:To study the morphological characteristic of human periosteal cells cultivated in vitro and to investigate the clinical effects of human periosteal cell transplantation on the repair of distracted bone gaps of human Method:To observe the morphological characteristic of human periosteal cells cultivated by the conventional method in vitro under optics and electronic microscope and to inject by way of skin periosteal cells cultivated in vitro into distracted bone gaps to treat the bone defect Result:Under optics microscope:neonatal periosteal cells showed shuttle,satiation,clarity and third dimension in early stage,then became cube or puncheon in split stage,and gradually became wide shuttle and irregular shape with a lot of secretion in telophase Under ultrastructure,the bodies of these cells showed fusiform,and there were a fat lot of microvilli on membranous wall and abundant endoplasmic reticula The cure rate of bone defect and nonunion of the patients was 73 percent,and that of bone delay recover was 100 percent In generally,the time of osteogenic connection of bone focus was 12 to 16 weeks Conclusion:Human periosteal cell can be greatly cultivated and proliferate in vitro Whoes cellular configuration has no distinct difference with progenerotion cells after anagenesis,the cultured cells can be used in transplantation The suspension of cells can be injected by way of skin into distracted bone gaps to facilitate the bone defects repaired