淫羊藿苷/壳聚糖/血小板血浆微球/羟基磷灰石复合材料治疗兔桡骨骨缺损疗效的实验研究

An Experimental Study on the Efficacy of Combined Graft(Epimedium-Chitosan-Hydroxyapatite Loaded with Platelet Rich Plasma Microspheres) on Bone Defect Formation

目的观察淫羊藿苷/壳聚糖/富血小板血浆微球/羟基磷灰石复合材料提高骨缺损愈合的疗效。方法48只新西兰大白兔随机分成3组:A组模型组(行骨缺损手术);B组富血小板微球羟基磷灰石PRP/CS/HA(行骨缺损手术,植入PRP/CS/HA复合材料);C组淫羊藿苷血小板血浆微球羟基磷灰石复合材料EP/PRP/CS/HA(行骨缺损手术,植入EP/PRP/CS/HA复合材料)。均植入6孔钢板(华创仿AO宠物用钢板);术后均观察12周。通过HE组织形态学检测、x线摄片、生物力学检测等检测方法,以评估不同疗效。结果与A组相比,12周时,X线提示B组骨折线稍模糊,骨痂密度开始增加;C组则显示骨折线模糊,骨痂生长良好,骨成熟度较高;同时感染率较前两组明显降低(P<0.01);生物力学结果显示,与A组相比,B组、C组显示骨痂强度明显增强,但统计学没用显著差异,与A组相比生物力学均差异明显(P<0.05)。组织形态学显示A组以纤维结缔组织为主,B组、C组则见大量骨组织形成,其中C组骨痂成熟度较高(P<0.05)。结论 EP/PRP/CS/HA复合材料具有促进骨折愈合作用,有望成为一种治疗骨缺损的良好方法。

Objective： To study the efficacy of using combined graft （epimedium-chitosan-hydroxyapatite loaded with platelet rich plasma microspheres） for bone defect repairing. Methods： 48 New Zealand white rabbits with radius bone defect were randomly divided into three groups： Group A： blank control group： bone defect opera- tion;Group B： combined graft group （chitosan-hydroxyapatite loaded with platelet rich plasma microspheres）; Group C： （Epimedium-chitosan-hydroxyapatite loaded with platelet rich plasma microspheres）. All animals were fixed with plate. Bone repairing efficacy was assessed by hematoxylin eosin histology,X-ray radiography and biomechanical testing methods in 12 weeks after operation. Results： Compared with Group A,X ray showed frac- ture line began to blur with increased callus （woven bone） in the 12th week in experimental group B and bone fracture line blurred with increased mature stage callus in group C. The postoperative infection rate was lower in group C and had significant difference as compared with the former two groups （P〈 0.01）. Biomechanical testing showed increased callus bending strength in both group B and group C as compared with group A with statistical significant difference. There were no statistical significant difference between group B and C. Hematoxylin eosin histology showed mainly fibrous connective tissue in group A while massive bone tissue formed in group B and C with mature stage bone tissue in group C. Conclusion： The combined graft （epimedium-chitosan-hydroxyapatite loaded with platelet rich plasma microspheres） is expected to be a possible method in bone defect treatment as it shows enhanced bone repairing.