β-磷酸三钙煅烧骨负载抗生素治疗慢性骨髓炎的实验研究

Beta-tricalcium phosphate sintered bone/antibiotics drug delivery systems for treating chronic osteomyelitis

背景:可生物降解抗生素载药系统具有载体材料可降解、抗生素释放完全、局部药物浓度高、抗感染效果好、全身不良反应小等优点。目的:观察负载庆大霉素的β-磷酸三钙煅烧骨可生物降解抗生素释放系统治疗慢性骨髓炎的效果。方法:取48只新西兰大白兔制作慢性骨髓炎模型,随机分为实验组与对照组,实验组骨缺损部位植入复合庆大霉素的β-磷酸三钙煅烧骨可降解抗生素释放系统,对照组骨缺损处植入β-磷酸三钙煅烧骨颗粒。结果与结论:实验组动物全身状态、伤口愈合情况、静脉血中白细胞及C-反应蛋白变化情况均好于对照组。实验组局部抗生素药物浓度在术后第1天内爆发释放,达到较高浓度,术后4周时仍能够维持在有效抑菌浓度10倍以上,但在保持局部组织药物浓度较高同时全身药物浓度较低,在术后3周基本在周围静脉血中不再能够检测到抗生素。表明负载庆大霉素的β-磷酸三钙煅烧骨可生物降解抗生素释放系统可较好治疗慢性骨髓炎。

BACKGROUND： Biological degradation antibiotics drug delivery systems possess some advantages, such as the biological degradation of the carrying materials, complete delivery of the antibiotics, higher density of part drug, better effectiveness of anti-infection and fewer systemic adverse reactions. OBJECTIVE： To observe the effectiveness of the antibiotics drug delivery systems of the 13-tricalcium phosphate sintered bone loading gentamycin for treating chronic osteomyelitis. METHODS： Forty-eight New Zealand white rabbits were selected to make the model of chronic osteomyelitis, and then randomly divided into experimental group and control group. The antibiotics drug delivery systems of the ^-tricalcium phosphate sintered bone loading gentamycin was implanted into the experimental group, and the particles of 13-tricalcium phosphate sintered bone were implanted into the defect site of the control group. RESULTS AND CONCLUSION： The general reactions, wound healing, changing of the white blood cells and C-reactive protein in the venous blood of the experimental group were better than those of the control group. The antibiotics drug concentration in the experimental group could achieve burst release and reach peak at the 1st day postoperation, then maintained a higher concentration that was 10 times higher than its effective bacteriostasis concentration within 4 weeks postoperation; but when there was a higher antibiotics drug concentration in the local tissue, the general drug concentration was lowered. At 3 weeks after operation, the antibiotics drug concentration in the venous blood could not be observed. All of above showed that the antibiotics drug delivery systems of the 13-tricalcium phosphate sintered bone loading gentamycin could treat chronic osteomyelitis better.