人工听骨链重建材料生物相容性、特性及修复喉软骨缺损的效果

Artificial ossicular chain reconstruction: biocompatibility, properties and laryngecartilage defect repair

背景:喉软骨缺损替代品较多,包括自体软骨、同种异体软骨以及金属支架等,这些材料在喉软骨缺损中均能取得理想效果,但是也存在许多不足。目的:研究人工听骨链重建材料生物相容性及其特性,探讨人工听骨链重建材料在喉软骨缺损中的修复效果。方法:(1)从新鲜人骨中提取骨形态发生蛋白,将羟基磷灰石高温煅烧后制备多孔羟基磷灰石,将获得的多孔羟基磷灰石听骨放入骨形态发生蛋白溶液中,制备骨形态发生蛋白-羟基磷灰石人工听骨链重建材料,分析材料的生物相容性及特性。(2)将40只新西兰雄性成年白兔随机分为多孔羟基磷灰石组和人工听骨链重建材料组,每组20只。制备新西兰雄性成年白兔喉软骨缺损模型,多孔羟基磷灰石组采用多孔羟基磷灰石材料进行修复,人工听骨链重建材料组采用骨形态发生蛋白-羟基磷灰石人工听骨链重建材料修复。结果和结论:(1)不同孔隙率人工听骨重建材料抗压强度和抗压强度差异有显著性意义;(2)骨形态发生蛋白-羟基磷灰石人工听骨链重建材料外表面空洞未形成对称性球状,外观表现为多边形,空隙尺寸为100-200μm;(3)2组大鼠分别植入骨形态发生蛋白-多孔羟基磷灰石和骨形态发生蛋白-羟基磷灰石人工听骨链重建材料后未见明显的不良反应。但人工听骨链重建材料组出现较多的结缔组织及明显骨性结节,且材料降解速度较快。(4)提示骨形态发生蛋白-羟基磷灰石人工听骨链重建材料具有良好的生物相容性和特性,利用其修复喉软骨缺损效果理想,具有较高的临床应用价值。

BACKGROUND： Defected Laryngeal cartilage has many alternatives, including autologous cartilage, al ograft cartilage and metal stents. Although these materials can achieve desired outcomes in laryngeal cartilage defect repair, certain limitations exist. OBJECTIVE： To investigate the biocompatibility and properties of artificial ossicular chain reconstruction materials, and to explore the effect of artificial ossicular chain reconstruction materials on laryngeal cartilage defect repair. METHODS： Porous hydroxyapatite otosteon was prepared by high-temperature calcination of hydroxyapatite, fol owed by cultured in bone morphogenetic protein solution extracted from fresh human bone to construct bone morphogenetic protein-hydroxyapatite artificial ossicular chain reconstruction material. And then, the biocompatibility and characteristics of the material were analyzed. Forty adult male New Zealand white rabbits were randomly divided into porous hydroxyapatite group and artificial ossicular chain reconstruction material group （n=20 per group）, and underwent repair with porous hydroxyapatite material and bone morphogenetic protein-hydroxyapatite artificial ossicular chain reconstruction material respectively after modeling of laryngeal cartilage defect. RESULTS AND CONCLUSION： There was a significant difference in compressive strength of artificial ossicular chain reconstruction materials with different porosities. No symmetry sphere formed in hol ows of the outer surface of the material, with polygonal appearance and with a pore size of 100-200 μm. There were no obvious adverse reactions in both two groups after implantation, but in the artificial ossicular chain reconstruction material group, numerous fibrous connective tissues and obvious bone nodules appeared, and the degradation rate of the material was faster. These results suggest that the bone morphogenetic protein-hydroxyapatite artificial ossicular chain reconstruction material exhibits good biocompatibility and properties, which wil obtain satisfactory outcomes for laryngeal cartilage defect repair. So, the material holds a great value of clinical application.