骨形态发生蛋白在股骨头坏死治疗中的应用

Application of bone morphogenetic protein in the treatment of femoral head necrosis

背景:股骨头缺血性坏死是世界性的难治性疾病。此病的治疗方法很多,目前尚缺乏一致公认的、疗效确切的治疗方法。骨形态发生蛋白是高效的骨诱导因子,将其直接或复合移植骨植入股骨头坏死区域,可诱导局部成骨,促进坏死骨修复,在实验和临床研究中均显示出良好的治疗效果。目的:探讨骨形态发生蛋白的作用及其治疗股骨头坏死的机制,总结骨形态发生蛋白治疗股骨头坏死的研究进展。方法:应用计算机检索CNKI期刊全文数据库和PubMed数据库(1995-01/2010-04)与骨形态发生蛋白及其治疗股骨头坏死有关的文章,检索词分别为"股骨头坏死;骨形态发生蛋白;发病机制;治疗"和"femoral head necrosis;bone morphogenetic protein;pathogenesy;therapy"。纳入所述内容与股骨头坏死的发病机制、骨形态发生蛋白的作用及应用、骨形态发生蛋白治疗股骨头坏死相关的文章。排除重复研究或较陈旧的文章。结果与结论:收集到300篇相关文献,排除270篇不符合标准的文献,共纳入30篇符合标准的文献。经分析得出以下结论:骨形态发生蛋白治疗骨折和骨缺损的疗效明确,骨形态发生蛋白在股骨头坏死的治疗过程中应用广泛,疗效满意,可以在很大程度上修复股骨头坏死清除死骨后形成的缺损。骨形态发生蛋白在保留股骨头的各种姑息性手术如髓芯减压术、截骨术、骨移植等传统治疗方法均可用骨形态发生蛋白辅助治疗,提高传统治疗方式的治疗效果。

BACKGROUND：Avascular necrosis of the femoral head（ANFH） is a world wide difficult controlling diseases.Though many methods are used for treating this disease,there is not an accepted one got precise curative effect.Bone morphogenetic protein（BMP） is an effective osteoinductive factor,which can induce local bone formation,promote necrotic bone repairing if implanted into necrotic region.OBJECTIVE：To observe the role and mechanism of BMP in the treatment of ANFH,and to summarize the relative research progress.METHODS：A compute-based research was performed in CNKI and PubMed for articles related to application of BMP in the treatment of ANFH using key words of ＂femoral head necrosis,bone morphogenetic protein,pathogenesy,and therapy＂ from January 1995 to April 2010.Relative documents concerning pathogenesis of ANFH,role of BMP,and BMP in the treatment of ANFH were included.The repetitive research or old data were excluded.RESULTS AND CONCLUSION：A total of 300 articles were collected and 30 papers were included in the final analysis.BMP not only received definite effects on treating bone fracture and bone defects,but also widely used for the treatment of ANFH,which can basically repair bone defects after removal of necrotic bone.BMP can be used as adjuvant therapy for palliative surgery,such as core decompression,osteotomy,or bone transplantation,which can raise the therapeutic efficacy of traditional surgery.