重组复合异体冻干骨修复节段性骨缺损的实验研究

EXPERIMENTAL STUDY OF REPAIRING SEGMENTAL BONE DEFECT WITH RECONSTITUTED FREEZE-DRIED BONE ALLOGRAFT

目的 探讨碱性成纤维细胞生长因子 (b FGF)和透明质酸凝胶 (HAG)复合异体冷冻干燥骨修复节段性骨缺损的能力及作用机制。方法 用新西兰大白兔 5 0只 ,两侧桡骨干处造成 15 mm缺损 ,采用四种不同的处理方法 :A组植入 b FGF、HAG与异体冻干骨的复合物 ;B组植入吸附 b FGF的异体冻干骨 ;C组植入含有 HAG的异体冻干骨 ;D组单纯植入异体冻干骨作为对照。每组肢体数为 2 5。在术后 2、4、6、8和 10周进行 X线片 ,组织学和放射性核素扫描检查 ,并测定钙含量。结果 A组在术后不同时间的骨代谢活性 ,新骨生成量和钙含量均高于 B组 (P<0 .0 5 ) ,B组高于 C、D组 (P<0 .0 5 ) ,C组与 D组无明显差异。 A组和 B组缺损分别于术后 8、10周完全愈合 ,而 C、D两组骨缺损在术后 10周仍未愈合。 结论 b FGF作为一种骨生长因子促进新骨生成 ;HAG作为缓释载体提高 b FGF的效能 ,它们复合异体冻干骨后能有效提高骨缺损的修复能力。

Objective To study the effect of basic fibroblast growth factor (bFGF) and hyaluronic acid gel (HAG) combined with freeze dried bone allograft in repairing segmental bone defect and to explore their mechanism. Methods The 15mm segmental bone / periosteum defects were created on bilateral radius in 50 New Zealand rabbits and were treated with four different kinds of implants on 25 radius respectively( group A: bFGF and HAG combined with freeze dried bone; group B: bFGF combined with freeze dried bone; group C: HAG combined with freeze dried bone; group D: simple freeze dried bone as a control). The repair of defect was observed radiologically and hitologically and were analyzed by radionuclide bone imaging and measurement of calcium contents at different periods. Results The new bone formation, bone metabolic activity and calcium contents of defects were higher in group A than in group B ( P< 0.05), and were higher in group B than in groups C and D( P< 0.05). There were no significant difference between groups C and D. The bone defects healed in the 8th week in group A, in the 10th week in group B, but did not healed in the 10th week in groups C and D. Conclusion As an osteogenetic factor, bFGF promotes the new bone formation; as a slow release carrier, HAG enhances the effectiveness of bFGF. The combination of bFGF, HAG and freeze dried bone allograft can repair the segmental bone defect more effectively.