双相陶瓷生物骨-骨形态发生蛋白-碱性成纤维细胞生长因子复合物修复股骨头坏死模型的实验研究

Biphasic Ceramic Biologic Bone, Bone Morphogenetic Protein, and Basic Fibroblast Growth Factor Complex Transplanted for Femoral Head Necrosis

目的观察双相陶瓷生物骨(BCBB)、骨形态发生蛋白(BMP)、碱性成纤维细胞生长因子(bFGF)复合物修复股骨头坏死(FHN)模型的效果。方法 32只新西兰成年大白兔共64侧股骨头,微波灭活建立股骨头坏死模型,随机分为A、B、C、D 4组,每组16侧。A组为空白对照,B组植入BCBB/BMP,C组植入BCBB/BMP/bFGF,D组植入自体松质骨。术后2周、4周、8周和12周分批处死动物,每组每次取材4侧股骨头。行股骨头大体解剖观察、X线摄片、组织学观察、血管免疫组织化学染色。结果大体解剖:12周时,A组有1侧股骨头塌陷,缺损区只有少量类骨组织形成;B组和C组有大量新骨形成,植骨区与宿主骨界限依然存在;D组植骨区与宿主骨界限不清,植骨区骨密度及骨结构接近宿主骨。X线摄片:12周时,A组缺损仍然存在,有1侧股骨头塌陷;B组和C组骨移植区呈高密度影,骨移植区与宿主骨界限模糊;D组骨移植区密度与宿主骨相当,与宿主骨界限不清。组织学观察:4周时,A组有少量类骨组织形成;B组有少量新骨组织形成,BCBB吸收不全;C组有大量新骨组织形成,BCBB吸收不全;D组有大量新骨组织形成,自体骨移植大部分吸收。4周、8周和12周时组织学新骨形成面积比较:D组和C组优于B组和A组,B组优于A组(均P<0.05),C组和D组间无显著性差异(P>0.05)。血管免疫组化染色:2周、4周和8周时,C组血管面积大于A组、B组、D组(P<0.05),A组、B组、D组间无显著性差异(P>0.05)。结论 BCBB/BMP/bFGF复合物具有较强的成骨和成血管能力,对FHN的修复能力与自体骨相当。

Objective To observe the efficacy of a kind of complex composed of biphasic ceramic biologic bone （BCBB）, bone morpho-genetic protein （BMP） and basic fibroblast growth factor （bFGF） on the repair of necrotic areas of the femoral head. Methods The femoral head necrosis model of 64 femoral heads in 32 rabbits induced with microwave heating were randomly divided into four groups, which im-planted with nothing （group A）, BCBB/BMP （group B）, BCBB/BMP/bFGF （group C） and with cancellous bone autograft （group D）. The specimens were harvested separately at the end of 2, 4, 8 and 12 weeks after operation. 4 femoral heads were taken off at each interval in ev-ery group. A series of examinations were carried out including of naked eyes and gross anatomic observation, X-ray, histology, and blood vessel immunohistochemical staining. Results In group A, 1 femoral head collapsed by the end of 12 weeks, and there was only a little oste-oid tissue formed. At the same time, a lot of new bone formed in group B and group C, and the boundary between the bone grafting area and the post bone still existed, but the boundary was unclear in group D, with the density consistent to the post bone. Under X-ray, the defect could be found and one femoral head collapsed in group A by the end of 12 weeks. The density of bone grafting area was high and the boundary to the post bone was unclear in group B and in group C. The density of bone grafting area was the same as the post bone and the boundary between them was unclear in group D. There was only a little osteoid tissue formed in group A by the end of 4 weeks. At the same time, there was a little new bone formed in group B, and BCBB was partly degraded. There was a lot of new bone formed in group C and group D, and BCBB was partly degraded in group C, but cancellous bone autograft was almost absorbed in group D. The new bone area by the end of 4, 8 and 12 weeks from more to less were：group C and group D （P〉0.05）, group B, and group A （P〈0.05）. At the end of 2, 4 and 8 weeks, the blood vessel area of group C was more than that of group A, group B, and group D （P〈0.05）. Conclusion The BCBB/BMP/bF-GF complex can induced osteoinduction and revascularization, to repair rabbit femoral head necrosis as effective as cancellous bone auto-graft.