【摘要】 背景:骨折是临床常见的骨科疾病,虽然大多数骨折可以通过坚强内固定等手术治疗实现一期愈合,但仍有相当比例的骨折愈合不良,最终导致骨缺损,而骨缺损部位的血管新生对骨缺损的修复起到至关重要的作用。基于内皮祖细胞促进组织血管发生的能力,其对骨再生和修复的辅助作用逐渐成为学界关注的焦点。目的:综述骨缺损疾病中使用内皮祖细胞促进血管发生及新骨生成的研究进展。方法:遵循PRISMA指南,检索CNKI、万方数据库和PubMed数据库1986至2019年期间关于内皮祖细胞辅助治疗骨缺损的动物实验、临床试验及其机制的文章,检索词分别为"内皮祖细胞,血管生成,血管发生,治疗,骨缺损""endothelial progenitor cells (EPCs),angiogenesis,vasculogenesis,therapy/treatment,bone defect",最后选择58篇文章纳入结果分析。结果与结论:①骨缺损时可以促进内皮祖细胞的激活与归巢;②内皮祖细胞可以促进血管发生;③内皮祖细胞是通过促进血管发生进而促进骨再生的;④将内皮祖细胞辅助治疗骨缺损推广至临床应用目前尚存在一些问题有待解决;⑤需要通过进行更多的临床试验,并且进一步深入研究内皮祖细胞参与血管发生的确切机制,为将来的临床应用提供数据支持,给大量骨缺损致残患者带来更好的治疗。更多还原

【Abstract】 BACKGROUND: Fracture is a common orthopedic disease in clinic. Although most fractures can heal by primary bone healing through surgical treatments, such as rigid internal fixation, malunion is liable to occur in some circumstances, eventually leading to bone defects. Neovascularization at the bone defect site plays a vital role in bone healing. Based on the pro-angiogenic ability of endothelial progenitor cells(EPCs), its capacity for bone regeneration and repair has gradually become the focus of attention. OBJECTIVE: To review the use of EPCs transplantation to promote vasculogenesis and osteogenesis in bone defects. METHODS: With the key words of "endothelial progenitor cells(EPCs), angiogenesis, vasculogenesis, therapy/treatment, bone defect" in Chinese and English, we performed a computer-based search in CNKI, WanFang and PubMed databases for relevant articles published from 1986 to 2019. Finally, 58 eligible articles were included in result analysis. During the literature retrieval, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS AND CONCLUSION: Bone defects can promote the activation and homing of EPCs. EPCs can promote vasculogenesis and further trigger bone regeneration. There are still some problems to be solved before the application of EPCs in the treatment of bone defects. More experiments need to be carried out to investigate the exact mechanism of EPCs in vasculogenesis. More clinical trials are warranted, providing data support for future clinical applications and giving better treatment to patients disabled by bone defects.更多还原