VEGF在脱细胞骨基质复合富血小板血浆修复颅骨缺损中的表达

Expression of vascular endothelial growth factor in repair of cranial bone defect with acellular bone matrix combined with platelet-rich plasma

目的:研究血管内皮生长因子(VEGF)在脱细胞骨基质(acellular bone matrix,ABM)复合富血小板血浆(platelet-rich plasma,PRP)修复兔颅骨缺损时的表达及分布,探讨富血小板血浆促进成骨的机制。方法:雄性新西兰大白兔24只,体质量1.5～2.0kg。在兔颅骨两侧分别建立一个1cm×0.5cm全层骨缺损区,同时去除该区骨膜,注意勿伤及硬脑膜。随机选择一侧骨缺损作实验侧,植入复合PRP的ABM;另一侧为对照侧,仅植入ABM。术后第2、4、8、12周末分别处死6只兔取材。免疫组织化学法测定骨缺损修复区血管内皮细胞生长因子(Vascular endothelial growth factor,VEGF)的表达;应用Image-proplus 5.0图像分析软件测量VEGF表达强度的灰度值。采用SSPS16.0软件包进行t检验。结果:术后2周,实验组VEGF呈强阳性表达,随后急剧下降,以后趋于平缓。对照组在术后2、4周呈阳性表达,以后平缓下降。两组相比,在第2、4周时差异均有显著性(P<0.05)。第8、12周时,2组表达差异无显著性。结论:VEGF在实验组早期阶段的强阳性表达,说明血管形成活跃。PRP促进骨修复的作用发生在植入后早期,启动了早期活跃的成骨。

PURPOSE：To detect the expression and distribution of vascular endothelial growth factor（VEGF） during the repair of rabbit cranial bone defect with acellular bone matrix（ABM） combined with platelet-rich plasma（PRP）,and investigate the mechanism of action of PRP in accelerating the repair of rabbit cranial bone defect.METHODS：Critical bone defects of 1.0 cm×0.5cm were created in bilateral cranial bone of 24 male New Zealand white rabbits.One side was randomly chosen as the experimental side,which was filled with acellular bone matrix with platelet-rich plasma;the other side filled with acellular bone matrix without PRP as the control side.Six animals of every group were killed according to different operation period and the implantations were taken off and studied by gross observation,imageology,histological analysis after 2,4,8 and 12 weeks of implant action.Immunohistochemical detection of the VEGF was performed.The results were analyzed with Students t test by SSPS 16.0 software package.RESULTS：2 weeks after surgery the expression of VEGF in the experimental group was higher than that in the control group.The expression of VEGF in the experimental group then declined in the next group seriously.There was significant difference between the staining gray of two groups at 2-and 4-week after surgery（P〈0.05）.There was no significant difference between the staining gray of two groups at 8-and 12-week after surgery（P〉0.05）.CONCLUSION：The expression of VEGF in-creased remarkably in the earlier period of the experiment group,then the blood vessel formation was activated.The promoting ossification happened in the early period.