碳酸化羟基磷灰石水泥修复骨缺损特征性效果的验证性实验(英文)

Characteristic effect of carbonated hydroxyapatite cement in repairing skeletal defect in a verified experiment

背景:碳酸化羟基磷灰石骨水泥是一种新型的骨修复材料,已应用在骨缺损临床治疗中。目的:通过动物实验观察碳酸化羟基磷灰石水泥修复骨缺损效果的特征。设计:配对设计、自身对照、验证性实验。单位:解放军骨科研究所和动物实验中心。对象:实验于2002-05/2003-01在解放军骨科研究所和动物实验中心完成。健康成年雄性杂种犬10只,体质量20～22kg。方法:10只杂种犬肱骨近端制作骨缺损动物模型,随机选择实验侧和对照侧。分别采用碳酸化羟基磷灰石水泥和高温烧结羟基磷灰石陶瓷修复骨缺损。分别于术后5d,4,8,12和16周处死动物,通过X射线和组织学观察其修复效果。主要观察指标:①两侧骨缺损处实体显微镜观察结果。②两侧骨缺损处X射线观察结果。③部分脱钙切片苏木精-伊红染色观察结果。④磨片Gimsa染色观察结果。结果:纳入犬10只,均进入结果分析。①两侧骨缺损处实体显微镜观察及X射线观察结果:实验侧碳酸化羟基磷灰石水泥界面结合紧密,随植入时间延长界面逐渐模糊。对照侧羟基磷灰石始终与骨界面清晰。②部分脱钙切片苏木精-伊红染色及磨片Gimsa染色观察:实验侧8周时新骨长入碳酸化羟基磷灰石水泥,16周时二者互相交错整合成为一体,并且在碳酸化羟基磷灰石水泥中出现围绕新生血管形成的骨岛。对照侧羟基磷灰石始终保持完整,与骨界面清晰,在16周时羟基磷灰石表面有新生骨沉积。结论:碳酸化羟基磷灰石水泥具有原位固化性能和生物相容性及骨传导活性,是一种较为理想的新型骨缺损修复材料。

BACKGROUND:Carbonated hydroxyapatite cement is a new type material for skeletal repair and hydroxyapatites have been applied in the clinical treatment of skeletal defect. OBJECTIVE:To observe the effective characteristics of carbonated hydroxyapatite cement on repair of skeletal defect by animal experiment. DESIGN:Paired design,self-controlled and verified experiment was applied in the research. SETTING:Orthopedic Institute and Animal Experimental Center of Chinese PLA. MATERIALS:The experiment was performed in Orthopedic Institute and Animal Experimental Center of Chinese PLA from May 2002 to January 2003,in which,10 healthy adult male mongrel dogs were applied,body mass weighted varied from 20 to 22 kg. METHODS:Animal model of skeletal defect was prepared on proximal ends of humeri of 10 mongrel dogs thydroxyapatitet were randomized into experimental side and control side.Ceramics repair of skeletal defect was done by carbonated hydroxyapatite cement and high-temperature sintered hydroxyapatite respectively.The animals were sacrificed on the 5th day,4th,8th,12th and 16th weeks successively after operation.The repair effects were performed with X-ray and histological observation. MAIN OUTCOME MEASURES:①Observation of bilateral skeletal defect under stereomicroscope.②Observation of bilateral skeletal defect in X-ray pictures.③Observation of partial decalcified sections with hematoxylin and eosin staining.④Observation of ground bone with Gimsa staining. RESULTS:Ten dogs were accepted and all entered the result analysis.①Results of stereomicroscopic and X-ray observations on bilateral skeletal defect:Osseointegration with carbonated hydroxyapatite cement was tight on the experimental side and the interface became unclear gradually with time lasting.The interface between hydroxyapatite and bone was still clear on the control side.②Observation of partial decalcified sections with hematoxylin and eosin staining and thydroxyapatitet of ground bone with Gimsa staining:On the 8th week on the experimental side,the new bone grew into carbonated hydroxyapatite cement,on the 16th week,the two parts were intermixed and integrated and the bone island was formed around newly generated vessels in carbonated hydroxyapatite cement.On the control side,hydroxyapatite still maintained integrated and the bone interface was clear between hydroxyapatite and bone.On the 16th week,the aggradation of newly generated bone presented on hydroxyapatite surface. CONCLUSION:Carbonated hydroxyapatite cement possesses solidification property in situ,biocompatibility and osseous conductive activity.It is the satisfactory new type material for repair of skeletal defect.