可注射性硫酸钙骨水泥的生物力学研究

Biomechanical study of injectable calcium sulfate cement

目的探讨塑性剂的类型及浓度对可注射性硫酸钙骨水泥(injectable calcium sulfate cement,ICSC)的抗压强度的影响。方法分别采用不同浓度的羧甲基纤维素(carboxymethylcellulose,CMC)、甲基纤维素(methylcellulose,MC)、透明质酸(hyaluronic acid,HA)、硬脂酸(stearic acid,SA)与半水硫酸钙机械混合;与生理盐水反应后,观察复合物的抗压强度;并记录ICSC自身性能的改变:如凝固时间、可注射性能。按塑性类型分为CMC组、MC组、HA组、SA组及单纯硫酸钙组;每组再按塑性剂的浓度分亚组:如1%、3%、5%MC组。结果单纯硫酸钙的抗压强度为(21±4.58)mPa,终凝时间为(3.86±0.09)min。不同浓度的SA对硫酸钙抗压强度的影响均不明显(F=1.593,P=0.266),但可明显延长凝固时间(F=29.868,P=0.000)。不同浓度CMC均明显降低硫酸钙的抗压强度(F=23.943,P=0.000),且凝固时间均延长至120 min以上。MC均能改善硫酸钙的抗压强度(F=4.808,P=0.034),并延长凝固时间(F=191.192,P=0.000);其中,1%、3%的MC明显改善抗压强度(P=0.007,0.027),而5%改善不明显(P=0.193)。不同浓度HA均能改善其抗压强度(F=3.818,P=0.058),并延长凝固时间(F=262.515,P=0.000);其中3%和5%明显改善(P=0.026,0.015),1%组不明显(P=0.062)。单纯硫酸钙的可注射量仅为20%;1%~5%HA组、3%和5%MC组高达90%以上;而CMC组无可注射性能。结论SA和CMC不能用于改善硫酸钙的抗压强度;而合适浓度的HA与MC不仅能改善ICSC的抗压强度,并能够提高可注射性能,但MC更能满足凝固时间的需求。

Objective To investigate the effect of different plasticizers on the compressive strength of injectable calcium sulfate cement(ICSC).Methods Hydroxymethylcellulose(CMC),methylcellulose(MC),hyaluronic acid(HA),stearic acid(SA)and self-made hemihydrate calcium sulfate were used to mix them,and the compressive strength of the complex was observed after reaction with normal saline;the changes of ICSC's own properties,such as setting time and injectability,were recorded.Results The compressive strength of calcium sulfate was 21±4.58 mPa,and the final setting time was 3.86±0.09 min.Different concentrations of SA had no significant effect on the compressive strength of calcium sulfate(F=1.593,P=0.266),but prolonged the setting time(F=29.868,P=0.000).CMC with different concentrations significantly reduced the compressive strength of calcium sulfate(F=23.943,P=0.000),and the setting time was prolonged to more than 120 min.Different concentrations of MC can improve the compressive strength of calcium sulfate(F=4.808,P=0.034),and prolong the setting time(F=191.192,P=0.000);among them,1%and 3%MC can significantly improve the compressive strength(P=0.007,0.027).Different concentrations of HA can improve the compressive strength(F=3.818,P=0.058),and prolong the setting time(F=262.515,P=0.000),of which 3%and 5%were significantly improved(P=0.026,0.015),while 1%group was not significantly improved(P=0.062).In addition,the injectable properties of HA,MC,stearic acid and CMC are better,respectively.Conclusion SA and CMC can not be used to improve the compressive strength of calcium sulfate,while HA and MC of appropriate concentration can improve the compressive strength of ICSC,and improve the injectable performance,but MC can make the coagulation time more in line with clinical needs.