重组人工骨修复实验性骨缺损影像学评价

Imaginological study on resombinant artificial bone substitute for experimental bone defects

[目的]探讨重组人胰岛素样生长因子-1(recomb inant hum an insu lin like growth factor-1,rhIGF-1)/珊瑚羟基磷灰石(coralline hydroxyapatite,CHA)自/体红骨髓(autogeneous red bone m arrow,ARBM)复合修复骨缺损的能力。[方法]成年中国家兔54只,随机分为3组,制成双侧桡骨中段11 mm骨-骨膜全层缺损模型,每组18只,每组动物左右两侧缺损分别随机植入2种不同材料:1组两侧分别植入材料A(CHA/ARBM/rhIGF-1)和B(CHA/ARBM);2组植入C(CHA/rhIGF-1)和D(CHA);3组植入E(自体皮质骨)和F(缺损旷置)。术后行大体、X线(2、4、8、12周)和99mTc-MDP骨扫描(12周)观察。[结果]A组X线片显示桥接骨痂生长良好,12周时缺损修复。12周99mTc-MDP骨显像示A和E组修复区高度核浓聚。[结论]CHA/ARBM/rhIGF-1重组人工骨移植可协同实现骨传导、骨诱导和骨再生作用,促进骨缺损重建。

[ Objective ] To investigate the ability of repairing bone defect with the combination of recombinant human insulin - like growth factor-1 （ rhIGF-1 ）, coralline hydrolyapatite （CHA） and autogeneous red bone marrow （ARBM） by way of imaginology. E Method] Bilateral middle radius periosteum -bone defects （11mm in length） were created in 54 Chinese rabbits, and were ramdonly devided into 6 groups （each group containning 18 radial defects of one forearm） ： group A, defects transplanted with rhIGF-1/CHA/ARBM, group B, with CHA/ARBM, group C, with rhIGF-1/CHA, group D, with CHA, group E, with antograft, group F, no implant. At 2,4,8, and 12 weeks postoperation, the repair effects of defects were evaluated by observation of gross appearance, roengenodiagnosis and radionuclide bone image assay. [ Result] In group A, radiological and bone density image analysis showed that the defects were bridged well at 12 weeks postoperatively and was significantly superior to those of any other groups （P 〈 0. 01 ） at each observing time points. The results showed by single photon emission computerized tomography revealed that the radioactivity of group A rhIGF-1/CHA/ARBM and group E autograft were mark increased than those of any other groups （P 〈0. 01 ）, but no significant defference between group A and group E （P 〉 0. 05 ）. [ Conclusion] The recombinant compound rhIGF-1/CHA/ARBM, which possesses the potential ability of osteogenesis, osteocondution and osteoinduction for bone defect repairing, can enhance bone healing and serve as a new type of bone substitute.