浓缩自体骨髓复合纤维蛋白胶修复兔桡骨陈旧性骨缺损

Application of Enriched Bone Marrow Compound with Fibrin Glue in Repairing Old Radial Bone Defect in Rabbits

目的采用浓缩自体骨髓复合纤维蛋白胶修复陈旧性骨缺损,初步探讨其促进成骨的机制。方法将36只新西兰大白兔随机平均分为3组:单纯纤维蛋白胶组(A组),纤维蛋白胶复合自体骨髓组(B组),纤维蛋白胶复合浓缩自体骨髓组(C组)。每只动物均在左侧桡骨中段制造长1.5 cm的段缺性骨与骨膜缺损,1个月后在骨缺损处分别植入3种方法制备的组织工程复合材料。取浓缩骨髓、纤维蛋白胶复合物行电镜观察、长期培养及细菌学培养。术后4、8、12周行X线检查、硬组织切片观察成骨效果,并行半定量分析。结果电镜下可见骨髓有核细胞与纤维蛋白胶相容性良好,无细菌污染,长期培养无致瘤性。X线观察显示B组和C组的修复效果明显高于A组。术后8、12周,C组的Yang氏评分分别为(9.348±0.364)和(12.664±0.388)分,明显高于B组的(7.984±0.229)(F=40.167,P=0.001)和(10.584±0.836)分(F=20.3647,P=0.004)。B组(F=36.004,P=0.001)和C组(F=155.141,P=0.000)术后12周的Yang氏评分均明显高于术后8周。随着时间的延长,组织学切片见B组和C组均有不同程度的骨缺损修复。结论自体骨髓或浓缩自体骨髓复合纤维蛋白胶可修复兔桡骨陈旧性骨缺损,单纯纤维蛋白胶无此作用。

Objective To explore the feasibility of using enriched bone marrow（BM） compound with fibrin glue（FG） in repairing old radial bone defect.Methods Totally 36 New Zealand rabbits were equally randomized into three groups： simple FG group,BM＋FG group,and enriched BM＋FG group.A 1.5-cm segmental bone defect was made at the left radial in each animal.After one month,the defect was implanted with the engineered bone.Before implantation,a compound of enriched BM with FG underwent electron microscopy,long-term culture,and bacteriological culture.Four,8,and 12 weeks after operations,the osteogenetc effect was evaluated using X-ray observation,HE staining,or Van Gieson staining,and a semi-quantitative analysis was performed.Results Electron microscopy showed enriched BM were compatible well with FG.No bacterial contamination or oncogenicity was observed after long-term culture.X-ray showed the repair effectiveness was significantly higher in BM＋FG group and enriched BM＋FG group than in simple FG group.Eight and 12 weeks after surgery,the Yang scores were significantly higher in enriched BM＋FG group than in BM＋FG group [（9.348±0.364）vs.（7.984±0.229）,F=40.167,P=0.001;（12.664±0.388） vs.（10.584±0.836）,F=20.3647,P=0.004].In addition,the Yang＇s scores at bone defects in BM＋FG group and enriched BM＋FG group were higher at the 12th week than in the 8th week.（F=36.004,P=0.001;F=155.141,P=0.000;respectively） The bone defects were repaired at varied degrees were histologically observed in BM＋FG group and enriched BM＋FG group during the observations.Conclusion Implantation of BM＋FG or enriched BM＋FG are effective in repairing old radial bone defects,while simple FG shows not such effect.