【作者】 吴小建；

【导师】 陈一心； 李延报；

【作者基本信息】 南京大学 ， 临床医学， 2011， 硕士

【摘要】 目的：研究羟基磷灰石涂层丝素蛋白(SF/HA)膜引导兔桡骨缺损再生的作用。方法：通过脱胶法制备SF膜,再通过交替浸渍方法制备SF/HA膜。取9只成年新西兰大白兔建立双侧桡骨中段10mm骨膜骨缺损模型,实验组6只,左侧(SF组)以SF膜卷成管状桥接缺损,右侧(SF/HA组)以SF/HA膜桥接,对照组3只双侧(空白组)不做处理。术后观察动物饮食、活动及伤口愈合情况等一般状况,术后2、4、8、12周行双前肢X线摄片观察骨缺损愈合状况,4、8、12周行CT三维重建并获取骨缺损区域横断面影像以了解骨缺损修复状况。根据以上结果进行引导性骨再生趋势评估。结果：一般状况：所有实验兔术后一般状况良好,无异常活动,饮食正常,术后切口均一期愈合,无感染征象。X线摄片：术后2周时,见各组桡骨缺损成功建立。4周时,SF组可见少量骨痂生长,远端成骨优于近端；SF/HA组未见明显骨痂生长；空白组则见骨痂生长,远端多于近端。8周时,SF组可见显著骨痂生长,量较4周时明显增多,远端成骨略优于近端,SF/HA组骨痂生长不明显；空白组有骨痂生长,主要分布于近尺骨侧。12周时,SF组可见骨痂进一步生长,远端骨痂与近端骨痂接近连接,两端成骨水平接近,骨缺损区域范围明显缩小,SF/HA组可见少量骨痂生长,但近端与远端之间仍残存大片骨缺损区域,空白组见骨痂生长,分布于缺损近尺骨侧,但近端与远端之间仍残存大片骨缺损区域。术后4、8、12周CT三维重建获取的骨缺损区域横断面影像结果支持X线摄片结果。引导性骨再生趋势评估：SF组中66.67%(4/6),SF/HA组中33.33%(2/6),空白组中0.00%(0/6)有引导性骨再生趋势。结论：SF膜可能引导兔桡骨缺损再生,而SF/HA膜则不能,需要进一步改进基于SF的膜材料以提高其引导性骨再生作用。更多还原

【Abstract】 Purpose:To study the bone regeneration guided by silk fibroin/hydroxyapatite (SF/HA) membrane in rabbit radii defects.Methods:After the SF membrane was prepared by degumming method, the SF/HA membrane was developed by alternate soaking method. The models of 10 mm segmental defects were established in both radii of 9 adult New Zealand white rabbits. 6 as experimental group, the left defect (Group SF) was bridged with SF membrane tube, the right defect (Group SF/HA) was bridged with SF/HA membrane tube. The other 3 as controlled group, both defects (Group Blank) were untreated. General condition of the rabbits, such as the diet, activity and wound healing were observed postoperatively. To observe the healing status of bone defects, X-ray examination was performed at 2,4,8 and 12 weeks postoperatively. Otherwise, computer tomography (CT) 3D reconstruction was performed and cross-sectional images of bone defects were acquired to observe the healing status of bone defects 4,8 and 12 weeks postoperatively. The trend of guided bone regeneration in every group was evaluated according to the results above.Results:General condition:General conditions of all rabbits were good, no unusual activity, abnormal eating or signs of infection were observed postoperatively. X-ray examination:Rabbit radii defects were established in all groups at 2 weeks postoperatively. At 4 weeks postoperatively, a small amount of callus growth was observed in Group SF, and the bone regeneration of distal end is better than the proximal. No obvious callus growth in Group SF/HA, and a small amount of callus growth in Group Blank, the distal better than the proximal. At 8 weeks, significant callus growth was observed in Group SF, and the volume increased than that at 4 weeks, the distal end is still better than the proximal. No obvious callus growth in Group SF/HA, and callus growth near the ulna in Group Blank. At 12 weeks, more growth callus could be observed in Group SF, and the distal is similar to the proximal. Both ends were almost connected, so the area of bone defect was significantly reduced. A small amount of callus growth in Group SF/HA, and residual large bone defect area existed between the proximal end and the distal. Otherwise, callus growth near the ulna in Group Blank, residual bone defect area was also large. And the results of X-ray were supported by the cross-sectional images of bone defects acquired by CT 3D reconstruction. The percentages of guided bone regeneration trend were 66.67%(4 of 6) in Group SF,33.33%(2 of 6) in Group SF/HA and 0.00%(0 of 6) in Group Blank.Conclusion:The bone regeneration could probably be guided by SF membrane, while couldn’t by SF/HA membrane in rabbit radii defects. Further improvements of SF-based membrane material is required to enhance its capacity in guided bone regeneration.更多还原