抗生素/β-磷酸三钙/多孔丝素蛋白支架修复兔桡骨骨缺损的实验研究

Experimental study of antibiotics/three calcium phosphate/porous silk fibroin scaffold repairing rabbit radial bone defect

目的探讨抗生素/β-磷酸三钙/多孔丝素蛋白支架修复兔桡骨骨缺损的效果。方法制备再生丝素蛋白胶囊型载药人工骨修复材料,成年大白兔16只,随机分为A组[不载药材料:SF(多孔丝素蛋白支架)+β-TCP(β-磷酸三钙)]、B组(载药材料:SF+β-TCP+万古霉素),每组8只(16例桡骨)。桡骨构建桡骨骨缺损模型后植入材料,于术后第28、56、84、112天观察兔的一般情况(感染发生后退出观察),并在第84天和112天时随机处死一半的兔子,观察骨愈合的组织学表现。结果 A组4只兔(8例桡骨)6~7d发生感染,B组无感染发生,A组感染发生率明显高于B组(χ~2=8.167,P=0.004);术后84d,A组2只兔(4例桡骨)及B组3只兔(6例桡骨)得到满意骨修复效果,组织学切片观察两组对比无明显差异,都可以看到新生骨质、少量β-磷酸三钙及丝素蛋白支架的残余,B组1只兔(2例桡骨)出现双侧假关节;术后112d,A组1只兔(2例桡骨)及B组4只兔(8例桡骨)得到满意骨修复效果,组织学切片观察与术后84d相仿且两组对比无明显差异,但可见更多的新生骨质,A组1只兔(2例桡骨)出现肢体屈曲痉挛,桡骨缺损修复效果不佳。结论抗生素/β-磷酸三钙/多孔丝素蛋白支架由于丝素蛋白的组织相容性好,多孔的结构允许外周的干细胞,包括成骨细胞向管壁内迁移,加之含有抗生素成分,对骨缺损修复及预防感染有较好的效果。

Objective To investigate the effect of antibiotics/three calcium phosphate/porous silk fibroin scaffold repairing rabbit radial bone defect. Methods Regenerated silk fibroin capsules for artificial bone repair materials were prepared. Sixteen adult white rabbits were randomly divided into group A（SF ＋ beta TCP for repairing bone defect） and group B（SF＋beta TCP＋vancomycin for repairing bone defect）. There were 8 rabbits（16 radius） in each group. Radial bone defect model was constructed after implanting materials. The rabbits were executed at 28,56,84 and 112 days postoperatively to observe the general situation. If infection occurred,rabbits were withdrawn from the observation. Half of the rabbits were executed after 84 and 112 days to observe the histologic findings of bone healing. Results Four rabbits in group A（8 cases of radius） occurred infection about 6 to 7 days after operation. Cases in group B were without infection,The incidence of infection in group A was significantly higher than that in group B（χ^2= 8. 167,P = 0. 004）. Bone repair effect in 2 rabbits in group A（4 cases of radius） and 3 rabbits in group B（6 cases of radius） was satisfactory. There was no significant difference between the two groups in the histological observation. Histological observation can see the new bone,a small amount of β-three calcium phosphate and silk fibroin scaffold residues,but 1 rabbit in group B was with bilateral false joints after 84 days. After 112 days,bone repair effect in 1 rabbit in group A（2 cases of radius） and 4 rabbits in group B（8 cases of radius） was satisfactory,Histological section observation result was similar to that after 84 days and no significant difference between the two groups,but more new bone mass was seen,only 1 rabbits in group A occurred buckling spasm.Conclusion Antibiotics/three calcium phosphate/porous silk fibroin scaffold has good histocompatibility. Porous structure allows peripheral stem cells,including osteoblasts to move within the tube wall. Also,it contains antibiotics. All these are good for bone defect repair and infection prevention.