钙磷骨水泥/复合脱蛋白骨关节移植血供重建的实验研究

Reconstruction of blood vessel of calcium phosphate cement and DPB/BMP/TNFαcomposite as bone-arthron graft material

目的 探讨钙磷骨水泥 /复合脱蛋白骨关节移植后的血供重建 ,以及与成骨能力的关系。方法 取新鲜新西兰大白兔股骨下段 (15 mm)制作成脱蛋白骨关节 ,并将 rh BMP、rh TNFα分别与脱蛋白骨关节和钙磷骨水泥进行复合。手术造成兔股骨下段 15 mm骨与关节缺损实验模型 ,将动物随机分成两组 ,A组 :将复合有 rn BMP和 rh TNFα的钙磷骨水泥在异体复合脱蛋白骨关节表面涂层和髓腔内填塞后 ,置换一侧股骨下端 ;B组 :单纯异体脱蛋白关节股骨下端移植 (对照组 )。植入后 4、8、12、16周分别行组织学检查以及 X线摄片 ,并于 16周行股动脉血管造影 ,了解局部血供重建情况。结果 A组在移植后第 4周即可观察到大量新生血管出现 ,网织状骨形成。至第 12 - 16周时 ,复合脱蛋白骨关节完全存活 ,断端愈合。光镜下各时期的成骨面积 A组均大于 B组。股动脉血管造影示 A组移植部位周围血管数量明显多于B组和正常组。结论 CPC/ DPB/ rh BMP/ rh TNFα复合脱蛋白骨关节具有良好的成骨能力 ,在体内能促进蛋白骨关节的血供重建。

Objective To study the relationship between the reconstruction of blood vessel and the ability of osteogenesis of calcium phosphate cement and allogenic deproteined bone arthron composite graft combined with rhBMP and rhTNFα. Methods We combined allogenic deproteined bone arthron and calcium phosphate cement (CPC) with rhBMP and rhTNFα respectively. A experimental model of 15 mm bone arthron defect in the femur of New Zealand rabbits was made, and the animals were divided into two groups at random: Group A, composite allogenic deproteined bone arthrons were coated with CPC/BMP/TNFα, and alsofilled in their medullary cavity, which were implanted into the defect of the femur. Group B, implanted with pure allogenic deproteined bone arthrons as the control group. In the 4th, 8th, 12th, 16th week after transplantation, regular roentgenography and the histological changes were studied. The femur artery angiography was performed to observe the reconstruction of blood vessel at the implantation area in the 16th week. Results In Group A, many vasoganglion and weave bone were observed in the 4th week. In the 12th^16th week, compositeallogenic deproteined bone arthron successfully survived and the fracture healed. New bone formation area in Group A was much larger than that in Group B in each period by the light microscope observation. Furthermore, femur artery angiography showed that the quantity of blood vessel at the implantation area in Group A was much more than that in Group B or normal group. Conclusion CPC/DPB/BMP/TNFα composite allogenic bone arthron has an excellent ability of osteohgenesis. It can stimulate bone formation and angiogenesis and accelerate the heal and replacement of DPB in vivo.