脱细胞牛心包膜材料与胶原膜引导骨再生的对照研究

COMPARISON OF ACELLULAR BOVINE PERICARDIUM MATERIAL WITH COLLAGEN MEMBRANE IN GUIDING BONE REGENERATION

目的 比较碳化二亚胺[1-ethyl-3（3-diaminopropyol）-carbodiimide，EDAC]交联脱细胞牛心包（acellular bovine pericardium，ABP）与胶原膜引导骨再生的作用和膜材料植入动物体内的转归。方法 健康雄性成年新西兰白兔24只，体重2．6～3．5kg，平均3．1kg。制备兔双侧下颌体7mm×7mm×5mm骨缺损模型，一侧骨缺损覆盖EDAC交联ABP（EDAC交联ABP组），另一侧覆盖胶原膜（胶原膜组）。术后4、8、16及24周各处死6只动物行大体、组织学观察及图像分析检测新生骨面积百分比及膜材料吸收替代百分比。结果 大体观察：术后4、8周EDAC交联ABP组膜材料完整，与缺损区正常骨粘连紧密；胶原膜组膜材料形态消失，骨缺损区轮廓欠清晰。术后16、24周EDAC交联ABP组骨缺损区创面平坦；而胶原膜组凹凸不平。组织学观察：术后4、8周EDAC交联ABP组胶原纤维排列规则，缺损区中央大量新生骨小梁；胶原膜组胶原纤维断裂，缺损区见大量新生骨小梁。术后16、24周，EDAc交联ABP组骨缺损区形成完整的骨桥，而胶原膜组骨缺损内局部长入纤维结缔组织。术后4、8周，两组新生骨面积百分比相近，16周EDAC交联ABP组为81．99％±3．92％，胶原膜组为76．35％±4．29％，组间差异有统计学意义（P〈0．05）。术后4、8、16及24周，EDAC交联ABP组膜材料平均吸收替代百分比分别为16．57％、27．94％、65．61％和85．72％；胶原膜组4周降解超过50％，8周已完全降解吸收。结论 EDAC交联脱细胞牛心包膜材料引导成骨的效率优于胶原膜。

Objective To compare the effect of guiding bone regeneration between l-ethyl-3 （3- diaminopropyol ）-carbodiimide （EDAC）-crosslinked acellular bovine pericardium （ABP） and medical collagen membrane （CM）. Methods Defects of 7 mm × 7 mm ×5 mm were created in both mandibles of 24 rabbits, which weighted 2.6- 3.5 kg. One side defect was covered with EDAC-crosslinked ABP（EDAC-crosslinked ABP group）, the other side defect with medical CM as control（CM group）. The ability of bone defect repair and change of both membrane materials were evaluated by gross observation, histological study and computer graphic analysis in the 4th, 8th, 16th and 24th weeks after operation. Results The surface of bone defects was even, consistent with adjacent normal bone in EDAC- crosslinked ABP group, while that of bone defects was of no evenness in CM group in the 16th and the 24th weeks. The histological observation showed that bone trabecula formed in the EDAC-crosslinked ABP group and fibrous connective tissue was seen in CM group in the 16th and the 24th weeks. There were no significant differences in new bone percentage of bone defects between 2 groups in the 4th and the 8th weeks（P〉0.05）. In the 16th week new bone percentage of bone defects was 81.99%±3.92% in EDAC-crosslinked ABP group and 76.35%±4.29% in CM group, showing significant difference （P〈0.05）. The average percentage of absorption in EDAC-crosslinked ABP group was 16. 57%, 27.94%, 65.61% and 85.72% in the 4th, 8th, 16th and 24th weeks respectively, while that in CM group was more than 50% in the 4th week and completely degraded at the end of 8 weeks. Conclusion EDAC crosslinked ABP has a better effect on guiding bone regeneration than CM in the repair of bone defects.