自体微小颗粒骨载万古霉素复式微球治疗兔骨感染性骨缺损的实验研究

An Experimental Study on the Composite Containing Small Particles of Autologous Bone and Dual Microspheres Loaded with Vancomycin for Infectious Bone Defect in Rabbits

目的检验兔自体微小颗粒骨载万古霉素PLGA/CS复式微球体内抗感染性及骨修复活性。方法按Mader J.T的骨髓炎造模方法造成双侧桡骨中上段骨髓炎模型兔48只;在植入实验前彻底清创,并造成双侧桡骨中上段1.5cm的骨缺损,将造模成功的兔随机分为3组,每组16只,A、B、C各组分别植入自体微小颗粒骨、自体微小颗粒骨与万古霉素、自体微小颗粒骨与载万古霉素复式微球后,在第2、4、8和12周四个时间点每组各取4只兔处死行延长区大体观察,X线正侧位片观察;同时在骨延长区取骨组织做组织学切片,HE染色观察新骨生成情况。结果影像学X线评分和组织学评分见,第2、4和8周时C组新骨形成均优于A、B组(P<0.05)。B组第2、4、8周新生骨形成优于A组(P<0.05);术后第12周影像学X线评分A、B、C三组分值差异均无统计学意义(P>0.05),术后第12周组织学评分B、C组成骨优于A组(P<0.05),B、C组比较差异无统计学意义(P>0.05)。结论载万古霉素复式微球与自体微小颗粒骨混合对兔感染性骨缺损的修复具有比较显著的促进作用,可以加快骨缺损成骨过程的新骨生成。

Objective To investigate the anti-infectivity and bone repair activity of autologous micro-particles loaded with vancomycin PLGA / CS double microspheres. Methods The rabbit osteomyelitis model in bilateral radial bone of 48 rabbits were established by Mader JT osteomyelitis modeling method. Debridement performed before implantation experiments and caused bilateral radial bone defects of the upper section of 1.5cm. 48 successful modeling rabbits were randomly divided into three groups： group A with tiny particles of autologous bone implants, group B with autogenous micro grain bone implant with vancomycin and group C with autogenous micro grain bone double vancomycin microspheres implantation, Four rabbits in each group were sacrificed at 2nd week, 4th week, 8th week, 12th week and the extension area was observed. X-ray film of bones was observed too and bones was taken from the bone extension area. Histological sections were made and the new bone formation was observed by HE staining. Results Radiographic scoring showed that the new bone formation of group C at 2nd week, 4th week and 8th week was better significantly than that of group A and group B at the same time （P〈0.05） . The bone formation of group B was better significantly than that of group A at 2nd week, 4th week and 8th week （P〈0.05）. There were no significant difference in radiographic scores among group A, B and C at 12th week after operation （P〉0.05）. Histological scoring of group B and group C was better significantly than that of group A at 12th week （P〈0.05）. Conclusion The combination of vancomycin microspheres and autogenous microgranular bone could promote the recovery of the bone defects in rabbits, and could accelerate the formation of new bone during osteogenesis.