脱钙骨基质复合牛骨形态发生蛋白与单纯脱钙骨基质修复兔桡骨缺损比较

An experimental comparison of repair capacity between transplantations of demineralized bone matrix composed with and without bBMP in rabbits radial segmental defect

目的 比较脱钙骨基质(DBM)复合牛骨形态发生蛋白(bBMP)和单纯DBM修复节段性骨缺损的能力。方法 32只新西兰大白兔采用桡骨15mm节段性骨缺损模型,随机分为2组:A组植入异体DBM与bBMP(10mg)复合材料;B组植入异体DBM。术后4、8、12、16周,进行放射学检查、病理组织学检查和计算机图象分析新生骨面积。结果 X线和组织学检查显示异体DBM与bBMP复合材料组的新骨生成、修复骨缺损能力优于异体DBM组,组织切片的计算机图象分析提示DBM+bBMP组修复新骨面积大于DBM组,两者之间差异有显著性(4、8、12周P<0. 05, 16周P<0 .01)。结论 异体DBM复合bBMP材料通过骨诱导和骨传导两种方式修复骨缺损,其修复骨缺损的能力要优于单纯DBM材料,是一种较为理想,具有高效成骨活性的植骨材料。

Objective To compare the efficacy of repairing segmental bone defect between demineralized bone matrix(DBM) composed with bovine bone morphogenetic protein (bBMP) and pure DBM. Methods 32 rabbits, which were divided into Group A and Group B in random, were undergone unilateral radial osteotomies to creat a 1.5 cm bone defect. Group A received DBM and bBMP (10 mg) composite implantation, and Group B with pure DBM. The bone healing of two groups was observed through radiographic and histological examinations and the new bone formation was calculated by computerized graphic analysis in 4, 8, 12 and 16 weeks postoperatively. Results X-ray and histological examinations demonstrated that the new bone formation and the capacity of repairing the bone defect in the Group A were better than those in Group B. The area percentage of new bone formation in Group A was larger than that in the Group B by computerized histological graphic analysis of new bone formation in the bone defect(P<0.05 in 4,8 and 12 weeks and P<0.01 in 16 weeks). Conclusions The mechanisms of bone defect repairing by DBM+bBMP composite are realized by bone induction and conduction in the defect area, and its capacity of repairing bone defect is better than pure DBM. It is an ideal and effective osteogenetic implant substitute.