自体红骨髓及其不同成分复合PCPC修复兔桡骨缺损的实验研究

The Experimental Study of Autologous Red Bone Marrow and the Different Composite Components PCPC Repairing Bone Defect

目的研究自体红骨髓复合多孔磷酸钙骨水泥对骨缺损的治疗效果,希望通过实验验证自体红骨髓中促进骨缺损愈合的相关成分。方法选择体质量范围在2.5∽3.0 kg的新西兰大白兔60只。实验中建造新西兰大白兔双侧桡骨骨缺损模型（骨缺损大小1.5 cm）。利用随机分组法将120侧桡骨骨缺损模型分为五组,分别为A、B、C、D、E组,每组24侧桡骨骨缺损模型,以E组作为实验对照组。A组：自体红骨髓＋PCPC;B组：骨髓单个核细胞＋PCPC;C组：无细胞成分骨髓液＋PCPC;D组：去上清液骨髓细胞成分＋PCPC;E组：单纯PCPC。标本采集及数据分析：获取标本时间分别为手术后第4、8、12周）,每个获取标本时间点每个实验组选取6只新西兰大白兔,其中3只行X线摄片,另外3只兔子处死后用于组织形态学研究,研究不同时间段中骨缺损模型中新生骨生产情况。结果利用改良Lane-Sandhu X线评分标准对标本X线结果进行评分并完成统计学分析。结果不同时间段实验标本的大体解剖学观察、X线摄片和组织学观察显示,在植入物内部骨细胞、骨小梁、骨基质、骨质重塑上,以及PCPC降解情况,ARBM接种PCPC复合人工骨组（A组）明显优于其他各组。Lane-Sandhu X线及组织学评分差异有统计学意义（P〈0.05）。结论新西兰大白兔自体红骨髓中的有形成分（如细胞成分）以及骨髓上清液中的无形成分（如生长因子）对骨缺损的修复均有促进作用。另外红骨髓中的有形成分（细胞成分）以及无形成分（含生长因子的骨髓上清液）在促进骨缺损的修复中存在协同作用。自体红骨髓中的有形成分（骨髓单个核细胞）在促进骨缺损愈合过程中起到主要作用,可以将红骨髓的促新骨形成作用应用于骨缺损的治疗中。

Objectlve To discuss the efficacy treatment by autologous red bone marrow （ARBM）and various components composite porous calcium phosphate cement （PCPC）bone defect in order to find the evident of autologous red bone re_arrow healing role in the bone defect. Through this study we provides experimental evidence for thee clinical Irealment about bone defects red bone marrow Iransplant. Method We select 60 healflay New Zealand white rabbits, weighing 2.5--3.0 kg. All animals were established experimental model of bilateral bone defect（1.5 cm）. All animals were completely random divided into A, B, C, D, E according to forelimbs（24 side per five groups）, which E was the control group. A group was implanted autologous red bone marrow in the bone defect site. Group B was implanted bone marrow mononuclear cells. Group C was implanted composite acellular components; D group was implanted composite bone marrow supematant cell components; E group was implanted with simple PCPC. we get the samples 4, 8 and 12 weeks in each group at each time point and six rabbits were randomly selected（three killed; three under anesthesia）to get X-ray exam, the killed three rabbits receive histological examination such as various periods of new bone formation. We make statistical analysis according to modified Lane-Sandhu X scoring and histological score. Result The gross anatomy, x-ray and histological observation at all time points showed that the bone cells, Irabecular bone matrix, bone remodeling, and PCPC degradation inside the implant, ARBM the composite of artificial inoculation （PCPC）group was better than the other groups. Lane-Sandhu X ray and histological score has statistically significant difference （P〈0.05）. Conclusion Autologous red bone marrow and growth factors have the effect on promoting bone defects as well as a synergistic effect in promoting bone defect repair process. Autologous red bone marrow can be used in the treatment of bone defect repair which the main-promoting ingredients was the bone marrow mononuclear cells.