可注射壳聚糖-β-磷酸三钙复合富血小板血浆的骨修复作用

Effect of injectable chitosan-beta-tricalcium phosphate with platelet-rich plasma on bone regeneration in vivo

目的以新型可注射生物材料壳聚糖-β-磷酸三钙（β—TCP）为支架，负载富血小板血浆（PRP）构建成复合体，观察其体内成骨效应。方法18只中国青山羊随机分为三组，每组6只，建立双侧胫骨平台下腔穴型骨缺损模型。空白组：骨缺损部不植入任何生物材料；单纯材料组：单纯植入可注射生物材料壳聚糖-β—TCP；PRP组：植入复合PRP的壳聚糖-β—TCP。于术后第4、8周取出骨缺损区标本进行大体、组织学切片观察，图像分析骨缺损区域骨组织的生成比例。结果大体标本显示4、8周时PRP组骨缺损部硬度均强于空白组、单纯材料组。组织切片显示空白组到8周时骨缺损区域仍未修复，仅在骨缺损边缘部分区域有少量类骨质形成，骨缺损区域多为纤维组织填充；单纯材料组骨缺损边缘区域有少量类骨质形成，骨缺损区域多为小的点片状新生骨组织，中央区域到8周时无明显新生骨组织形成；PRP组骨缺损边缘区域类骨质较单纯材料组增多，骨缺损中间部多为点片状新生骨组织，骨缺损中央区同中间部相似，见点片状新生骨组织。术后4周空白组、单纯材料组、PRP组的成骨面积百分比分别为（8．79±3．63）％、（14．49±3．72）％、（24．18±5．38）％，8周时分别为（15．41±4．21）％、（25．36±5．37）％、（30．71±4．39）％，4周、8周PRP组骨修复效果均优于其他两组（P〈0．05）。结论负载PRP的壳聚糖-β—TCP具有良好的骨修复效果，PRP在体内早期对骨组织修复有促进作用。

Objective To study the effect of a novel injectable scaffold material, chitosan-betatricalcium phosphate （TCP） combined with platelet-rich plasma （PRP） on repairing bone defects in goats. Methods The model of bone defect was created in 18 Chinese goats, below the bilateral tibial plateaus of which a circular hole of 1.2cm in diameter was made. The animals were divided into 3 groups： a blank group where nothing was embedded into the bone defect; a simple material group where chitosan-beta-TCP was embedded into the bone defect; a compound material group where chitosan-beta-TCP combined with PRP was used. At 4 and 8 weeks after operation, samples were harvested from the defect zone for evaluation of the effect of bone regeneration by histological and image analyses. Results At 4 and 8 weeks after operation, the hardness of the bone defect zone in the compound material group was higher than that in the other 2 groups. At 8 weeks, histological slices showed the bone defects in the blank group were not restored, but only invaded by fibrous tissue with only a little osteoid formation at the boundary. In the simple material group, some osteoid formed at the boundary and small punctiform or lamellar new bone tissues in the defect area but without obvious new bone formation at the center. In the compound material group, the osteoid at the boundary was obviously more than in the other 2 groups and there were small punctiform or lamellar new bone tissues at the center of defect. Image analysis showed that the areas of bone formation in the blank, simple material and compound material groups were respectively 8.79 ±3.63, 14.49 ±3.72, 24. 18 ±5.38 at 4 weeks and 15.41 ±4. 21, 25.36 ±5.37, 30. 71 ±4. 39 at 8 weeks. The bone regeneration in the compound material group was better than that in the other 2 groups （ P 〈 0.05 ）. Conclusion The effect of injectable chitosan-beta-TCP combined with PRP on repairing bone defects is good, for PRP can promote bone regeneration in vivo at an early stage.