利用膜技术和组织工程化生物活性骨修复骨缺损的实验研究

Experimental Studies on the Combined Application of Membrane Guide Tissue Regeneration and Tissue Engineering Biological Active Bone in Healing Bone Defects

目的 将膜引导组织再生 (MGTR)技术和接种有同种异体成骨细胞的烧结骨联合应用修复骨缺损 ,为骨组织工程学修复骨缺损提供一种新的模式。方法 48只成年新西兰大白兔 ,随机分为A、B、C三组 ,建立兔桡骨不愈合模型 ,A、B组均植入活性烧结骨 ,且A组以聚乳酸膜管包裹 ,C组为空白对照组。术后 2、 4、 8、 1 2周行X线检查 ,并处死动物 ,行大体标本和组织学观察。结果 C组无一例骨缺损修复 ,A组骨缺损修复较理想 ,B组骨再生和髓腔重建较A组缓慢 ,1 2周内有 2例尚未骨性愈合。结论 复合成骨细胞的异种煅烧松质骨体内成骨可靠 ;将MGTR技术和该活性骨联用 ,加速了骨愈合。膜的作用机理可能为 :①物理屏蔽作用 ,阻止结缔组织长入缺损处 ,防止接种于载体上的成骨细胞的丢失。还间接起到收集骨髓基质干细胞和各种骨生长因子的作用。②膜下间隙提供骨再生的微环境 。

Objective To provide a new tissue engineering model for healing bone defects,we utilized membrane guided bone regeneration procedure and calcined bone transplanted with osteoblasts allograft.Methods Fourty-eight New Zealand adult rabbits were divided randomly into three groups A?B?C In group A?B,active calcined bone were implicated into the defects of the radius;in group A the defects were enveloped with polylactic acid membrane wrapped as a tube;in group C the untreated defect served as control.General observation,histological and radiological studies were performed at 2?4?8?12 weeks after surgery.Results The control side showed non-union.Satisfactory healing of the defect was seen in all specimens of group A,the velocity of bone regeneration and marrow luminal reconstruction in group B was slower than that in group A.Two cases of the defects in group B didnt heal within 12 weeks.Conclusion The active calcined bone allograft has the credible effect of bone formation in vivo.The combined application of MGTR and active bone accelerated the healing of bone.The possible mechanisms of guided membrane involve:①physical prevention:keeping the connective tissue out of the defective area,preventing the loss of osteoblasts and collecting marrow stromal stem cells and growth factors.②The submembrane space serves as micro-environment of bone regeneration and the guided membrane can increase the amount of bone regeneration.