肌瓣包裹自体气管移植体复合BMP诱导软骨再生

BMP-induced cartilage regeneration in tracheal autograft with muscular wrapping

目的:研究BMP复合肌瓣在自体移植中对软骨再生的作用.方法:将15只杂种犬随机等分为3组,均切取颈部5环气管段作为移植段,行自体移植.A组:肌瓣包裹组;B组:肌瓣复合BMP/I型胶原复合物组;C组:空白对照组.术后1,2,4,8及10wk处死动物取材,观察和比较实验动物存活情况、移植体气管标本的大体和组织学改变,新生微血管密度(MVD)等指标,用改良钙-钴法测定软骨组织中碱性磷酸酶(ALP)的分布.结果:A,B组移植体均有不同程度的软骨再生:C组基本无再生;B组最明显.术后8wk前,ALP染色阳性面积有统计学意义(t=3.269,P<0.05),在术后8wk以后其差别无统计学意义.结论:BMP可提高移植段软骨的ALP表达,抑制软骨吸收.肌瓣包裹移植段,能够诱导出新生血管,利于软骨再生,二者复合可有效促进软骨再生.

AIM： To study the regeneration of cartilage by rhBMP-2 in tracheal autograft with muscular wrapping. METHODS： Fifteen mongrel dogs were randomly and equally divided into 3 autotransplanted groups： group wrapped with muscle （Group A）, group wrapped with mus- cle and implanted with rhBMP-2 （Group B） and group with no treatment （Group C）. A five-ring cervical tracheal segment was harvested as the autograft. The animals were sacrificed at 1, 2, 4, 8 and 10 weeks postoperative. The general conditions of animals, gross and histological character of the specimens and microvessel density were examined and modified Ca-Co method was used to detect alka- line phosphatase （ ALP）, RESULTS： Little regeneration of cartilage was found in Group C while obvious regeneration of cartilage was found in Group A and Group B. Significant difference was found in ALP within 8 weeks after operation between the three groups, with Group B the highest, followed by Group A and then Group C, while no significant difference was found in ALP 8 weeks after operation be- tween the 3 groups. CONCLUSION： Local use of bone morphogenetic protein （BMP） may up-regulate ALP in tracheal cartilage and inhibit the absorption of tracheal cartilage. Muscle wrapping can increase the microvessel density and RhBMP-2 helps to maintain tracheal＇s structure.