带蒂骨膜包裹脱蛋白骨、血管内皮细胞生长因子复合体修复关节端缺损的实验研究

Repair of extremity defects using pedicle periosteum wrapping compound of deproteined bone and vascular endothelial growth factor

目的 探讨带蒂骨膜包裹同种异体脱蛋白骨 (DPB)、血管内皮细胞生长因子 (VEGF)复合体移植后与受体的愈合能力及成软骨能力。 方法 将 30只新西兰大白兔随机分成甲、乙、丙三组 ,每组 10只 ,2 0个膝关节。甲组以带蒂骨膜包裹DPB复合VEGF植入受体 ;乙组以带蒂骨膜包裹DPB植入作实验对照 ;丙组单纯DPB植入作空白对照。术后 2 ,4 ,6 ,8周通过大体形态X线、光镜和电镜检查评判移植物与受床愈合及软骨生长情况。 结果 三组均可获DBP与受体生物愈合 ,甲组DPB与受体愈合速度较乙、丙组显著增快 (P <0 .0 5 ) ;乙组与丙组间差异无显著性意义(P >0 .0 5 ) ;甲、乙组均能诱发软骨形成 ,但甲组生成软骨速度和质量优于乙组 (P <0 .0 5 )。 结论 DPB移植后能获与受体牢固生物愈合。将带蒂骨膜包裹DPB后能诱发关节软骨生成。DPB复合VEGF后 ,能增进DPB与受体愈合和软骨形成。

Objective To observe the capacities of the compound of deproteined bone (DPB) and vascular endothelial growth factor (VEGF) after transplantation of compound of DPB and VEGF in bone healing and chondrogenesis. Methods Thirty rabbits were randomly assigned into 3 groups (10 rabbits per group, 20 joints). In Group A, the donor bones were covered with periosteum after implantation of the compound of DPB and VEGF. In Group B, the implanted DPB wrapped by pedicle periosteum was used as the control. Group C with only donor bone implantation was used as the blank control. The bone healing and the chondrogenesis of the implant with the receptors were observed with X-ray, electron and optical microscopes 2, 4, 6 and 8 weeks after operation. Results In all groups, DBP had satisfactory bone healing with receptor bone and the bone healing in the Group A was significantly quicker than that in the Groups B and C ( P <0.05). There was no significant difference in bone healing in the Groups B and C ( P >0.05).Chondrogenesis was induced in the Groups A and B; however, the speed and quality of chondrogenesis was better in the Group A than that in the Group B (P<0.05). Conclusions The transplanted DPB can achieve reliable biological bone healing with receptor bone. Articular chondrogenesis can be induced when DPB is covered with pedicle periosteum. Bone healing of DPB with receptor bone and chondrogenesis can be improved by applying compound of DPB and VEGF.