骨髓间充质干细胞结合硼硅酸盐玻璃支架修复兔股骨头坏死

Experimental study on bone marrow mesenchymal stem cells combined with boron silicate glass in the repair of rabbit femoral head necrosis

目的通过应用硼硅酸盐生物玻璃13-93B3材料和组织工程技术,探索骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)结合硼硅酸盐生物玻璃在股骨头坏死修复中的效果。方法制备硼硅酸盐生物玻璃和成骨诱导的BMSCs复合体。应用新西兰大白兔36只分别建立股骨头坏死动物模型,数字抽签随机分为3组:对照组未植入任何材料;单纯植入组,为在股骨头骨坏死区单纯植入硼硅酸盐玻璃;复合植入组,为在股骨头骨坏死区植入硼硅酸盐玻璃并BMSCs复合体。应用影像学Lane-Sandhu X线片评分和组织学新生骨小梁面积率分析各组术后4、8、12周的股骨头缺损修复情况。结果对照组在造模后骨坏死缺损区域无明显成骨修复,以纤维组织增生为主,最终股骨头塌陷,第12周的Lane-Sandhu X线片评分为(0.35±0.16)分,新生骨小梁面积率为4.40%±0.34%。单纯植入组硼硅酸盐玻璃逐渐被新生骨替代而降解,骨小梁分布欠均匀、无股骨头塌陷,第12周的Lane-Sandhu X线片评分为(6.41±0.34)分,新生骨小梁面积率为38.10%±1.11%。复合植入组骨缺损区逐渐出现成骨修复反应,复合材料同步降解,骨小梁分布均衡、无股骨头塌陷,第12周的Lane-Sandhu X线片评分为(9.78±0.28)分,新生骨小梁面积率为68.20%±2.16%。通过对第4、8、12周的Lane-Sandhu X线片评分及新生骨小梁面积率统计学分析,复合植入组分别与对照组、单纯植入组比较,差异均有统计学意义(均P<0.05)。单纯植入组和复合植入组在治疗股骨头坏死成骨方面效果好于对照组,其中复合植入组的成骨效果较单纯植入组更好。结论采用BMSCs复合硼硅酸盐玻璃修复骨缺损将为股骨头坏死治疗提供新的材料及方法,对早期股骨头坏死的治疗有较好的应用前景。但是这一技术若要真正应用于临床实践,仍尚需大量的基础实验进行探索。

Objective To explore the effect of bone marrow mesenchymal stem cells(BMSCs)combined with boron silicate glass in the repair of femoral head necrosis by13?93B3and tissue engineering technology.Methods The osteoblast complexes induced by boron silicate glass and BMSCs were prepared.Thirty-six New Zealand white rabbits were divided into3groups.The animal model of femoral head necrosis was established.The animals in control group were not given any treatment,those in simple implant group were treated with the implantation of the boron silicate glass,and those in complex implant group were subjected to the implantation of the boron silicate glass and BMSCs.At4th,8th,and12th week after implantation,the femoral head imaging and histological results were analyzed.Results The results showed bone defect area incontrol group was not obviously repaired and replaced by fibrous tissue hyperplasia,and collapse occurred.Lane-Sandhu scores were0.35±0.16and new bone trabecular area rate was4.40%±0.34%at12th week.In simpleimplant group,borosilicate glass was gradually replaced by new bone and degraded,trabecular bone evenly distributed,and no collapse occurred.Lane-Sandhu scores were6.41±0.34,and new bone trabecular area rate was38.10%±1.11%at12th week.In complex implant group,bone defect area was repaired gradually andosteogenesis?reaction appeared,and the trabecular bones evenly distributed,borosilicate glass was degraded,atthe same time,the femoral head had no collapse.Lane?Sandhu scores were9.78±0.28at12th week and newbone trabecular area rate was68.20%±2.16%.Imaging results showed Lane?Sandhu scores in complex implantgroup were significantly higher than in control group and simple implant group at4,8and12weeks after treatment(P<0.05).The rate of new bone trabecular area in complex implant group was significantly higher than in other two groups(P<0.05)at4th,8th and12th weeks after treatment.Conclusion BMSCs combined with boron silicate glass13-93b3compound treatment offers new strategy to cure ONFH,and it shows a promising application prospect.More experimental evidence is needed to confirm the effectiveness of this method.