【摘要】 目的 探讨能谱CT定量评价重组人骨形态发生蛋白2(rhBMP2)促进胫骨骨缺损骨搬移术后牵张期成骨疗效评价的价值。方法 选取9例接受Ilizarov技术胫骨骨搬移术及搬移区加用rhBMP2患者为观察组，选取同期行单纯Ilizarov技术胫骨骨搬移术患者9例为对照组。收集患者分别于搬移开始后1、2、3个月能谱CT检查数据，观察搬移区新生骨形成情况、搬移区基物质对HAP(water)含量及增量、搬移区能谱曲线斜率。2组结果进行对比分析。结果 随着搬移时间的延长，搬移区范围增大，新生骨生成的范围增大、密度增高。第1、2、3个月测得搬移区HAP(water)的含量增多，能谱曲线斜率增大，观察组明显大于对照组，比较差异有统计学意义(P<0.05)。同时搬移区HAP(water)的增量观察组大于对照组，第1个月差异有统计学意义(P<0.05),第2、3个月差异无统计学意义(P>0.05)。结论 术后能谱CT,可用于评估搬移区新生骨形成情况，并可以量化搬移区成骨数量和质量，有助于评价rhBMP2在牵张成骨的牵张期疗效，对于骨再生新型材料的临床前评估有潜在的应用价值。更多还原

【Abstract】 Objective To evaluate the value of energy spectrum CT in quantitative evaluation of recombinant human bone morphogenetic protein-2(rhBMP-2) in promoting the effect of distraction osteogenesis in the stretch period after tibial bone transfer.Methods Nine patients who underwent Ilizarov technique for tibial bone transfer and transfer zone plus rhBMP-2 were enrolled in the observation group.Nine patients who underwent Ilizarov technique for tibial bone transfer were included in the control group.The CT scan data were collected after 1,2,and 3 months after the patient’s tibial bone was transfered,and the new bone formation in the transfer area,base material HAP(water) content and increment in the transfer area,and the slope of the energy spectrum curve of the transfer area were observed.The results of two groups were compared and analyzed.Results With the extension of the transfer time,the range of the transfer zone,the range of new bone formation and its density were increased.In the first,second and third months,both the HAP(water) content of the moving area and the slope of the energy spectrum curve were increased.The index of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The HAP(water)increment of the transfer area was measured,and the index of the observation group was larger than that of the control group,and the difference was statistically significant in the first month(P<0.05).There was no significant difference in the indicators of the second and third months(P>0.05).Conclusion Postoperative energy spectrum CT can be used to evaluate the formation of new bone in the transfer area,and can quantify the number and quality of distraction osteogenesis in the transfer area.It is helpful to evaluate the effect of rhBMP-2 in the stretch stage of distraction osteogenesis and has potential application value for preoperative evaluation of new bone regeneration materials.更多还原