【作者】 郑军；

【导师】 齐新生；

【作者基本信息】 东南大学 ， 外科学， 2005， 硕士

【摘要】 目的:研究复合了BMP及bFGF的新型双相钙磷陶瓷(HA/TCP;1:1)在体内诱导成骨的能力和其促进骨缺损修复的机制,观察作为载体材料的新型双相钙磷陶瓷对细胞因子释放的调控作用,从而为临床的应用提供实验依据。方法:1.将新型双相钙磷陶瓷(HA/TCP;1:1)分别与bFGF和/或BMP复合。2.将3组生物材料:实验组(BMP+ bFGF +HA/TCP)、对照组A(BMP+ HA/TCP)、对照组B(HA/TCP)分别植入兔骶棘肌肌袋内,2周、4周取材检测各组的成骨量,碱性磷酸酶染色以及镜下观察成骨情况。3.手术造成兔双股骨中下段4mm×4mm×12mm的缺损,实验动物依所用实验材料的不同共分为三组:实验组(BMP+ bFGF +HA/TCP组)、对照组A(BMP+ HA/TCP组)、对照组B(HA/TCP组),分别植入各组实验材料,于4周、8周、12周取材,通过HE染色,X线以及计算机图像分析,比较各组缺损的修复情况。结果:1.在异位成骨实验中,2周和4周的异位成骨量检测显示:实验组的成骨活性较其它两组优,有显著性差异(P<0.05)。光镜下见实验组术后2周大量的软骨细胞形成并可见编织骨,有典型的软骨成骨表现, 4周时可见板层骨及骨髓成形。2.在骨缺损实验中,实验组在软骨诱导、小梁骨的形成数量、骨缺损修复等方面均明显优于对照组A及对照组B。植入后4周可见大量的软骨细胞、成骨细胞、胶原组织及较多的小血管,骨小梁粗大、规则。8周时编织骨小梁逐渐改建为成熟的板层骨,出现髓腔结构,骨缺损基本修复,仅骨表面残留有较多针尖大小虫蚀样小洞。12周时完全修复,骨塑形好、表面光滑。对照组A:8周时骨缺损大部修复,但骨缺损上段残留一不规则形状的未修复区,骨表面血管长入较少。12周时完全修复,但表面不够光滑。对照组B:较前两组比形成的骨小梁纤细,稀疏,12周时骨缺损基本修复但骨质较薄,材料吸收不明显。结论:1.复合了BMP及bFGF的新型双相钙磷陶瓷材料有较强的成骨活性,可以促进骨缺损的修复。2.由于bFGF可以刺激血管生长,加快骨的矿化,与BMP合用可以加快新骨的形成。3.骨缺损处的骨修复主要通过软骨成骨,是由周围向中间,由血供好向血供较差的部位,多个成骨点共同开始修复,长入缺损处的微血管为不同的成骨点提供血供,直至骨缺损修复完成。4.新型双相钙磷陶瓷与人类骨组织中的无机成分相似,具有独特的表面结构,是一个吸附细胞因子的良好缓释载体。5.材料的降解和骨缺损修复进程有密切的关系,是一个相互促进的过程。更多还原

【Abstract】 Objective: To investigate the ability of osteogenesis, repaired effects and possible mechanism with the compound of HA/TCP(1:1),BMP and bFGF.Methods:1: HA/TCP(1:1) was combined with BMP and bFGF.2: Muscle pouches of the rabbits were implanted with HA/TCP+BMP+bFGF, HA/TCP+BMP and HA/TCP . The effect of ectopic bone formation was evaluated by histology, biochemical examination of Alkaline phosphatase in 2 weeks and 4 weeks after operation; and the new bone was weighted in in 2 weeks and 4 weeks of postoperation to compare the activity of bone formation.3: A 4mm×4mm×12mm bone defect experimental model in both thighbone of rabbits was made, the animals were divided into three groups at random, HA/TCP carrier with bovine BMP 15mg and bFGF 6000AU was implanted in the experiment group. HA/TCP carrier with bovine BMP 15mg was implanted in the control group A. And HA/TCP was implanted in the control groupB. In vestigation of the bone defect was made by means of gross observation. X-ray examination, histology of HE and Masson staining in 4 weeks, 8 weeks, 12 weeks after operation were studied and new bone formation was measured by Image analysis.Results:1.The activity and new bone quantity of experiment group(HA/TCP+BMP+bFGF) was significantly higher than in control group A(HA/TCP+BMP),control group B(HA/TCP)(P<0.01). Two week after experiment group, the chondrocy induced in muscle pouches, the woven b2. The bone defect in the experimental group has excellent repair than one was seen, and the trabecular bone was formed in four week.that seenin the control group A and control group B., both bone union and the period of bone mature were earlier than that seen in the control A and control groups B. In gross observation, the implantations were adhered to the host bone well in four weeks, the implantations was bony healed with host bone in eight weeks, and some of the implantations were replaced by new formation bone in 12 weeks. In histological examination of four week after operation, lamellar bone was found, and eight weeks after operation, implant was incorporated to host bone end by end through cortical bone, and new bone marrow was found to invade into the implant. Furthermore, the outer part of implant was completely substituted by new cortical bone 12 weeks after operation. In addition, the histological study pointed out that the new bone arranged in type of various bands which were in subsequent transition. There is significant difference between 4 weeks and 8 weeks, and 4weeks and 12 weeks, but no significant difference between 8 weeks and 12 weeks of the quantity of new bone.Conclusion:1. The compound of HA/TCP,BMP and bFGF possesses much high inductive potentialties and the ability of rebuilding bone defect.2. Since bFGF has positively inductive or stimulative effect on tissues, such as bone, cartilage, muscle, BMP combined with bFGF can apparently promotion effect on the repairing process of bone defect.3. The porous HA/TCP is a good scaffold material and can be used as bone substitutes clinically.4.Material degradation has close relation with the course of rebuilding bone defect,which is interactional.更多还原