【摘要】 目的在体外和动物体内条件下研究低频超声对抗生素骨水泥(antibiotic-loadedbonecement,ALBC)的促释放作用及其规律。方法制作载万古霉素ALBC的体外试件和体内试件。分别将质量分数为5%和10%的ALBC体外试件随机分为对照组、100mW/cm2超声组和300mW/cm2超声组。所有试件于40mlPBS中浸泡8h后,超声组接受超声干预30min,观察浸泡24h内药物累积浓度的变化。另取健康新西兰大白兔16只,将质量分数为7.5%的ALBC植入髋关节后随机分为对照组和超声组,每组8只。超声组于术后不同时间接受超声干预30min(300mW/cm2),术后5d内定时检测引流液和尿液中万古霉素浓度,术后4周检测ALBC残余药量。结果体外条件下10%100mW/cm2超声组和10%300mW/cm2超声组在浸泡24h后的药物释放分别较10%对照组增加71.77%、73.62%,5%100mW/cm2超声组和5%300mW/cm2超声组分别较5%对照组增加13.03%、23.78%。超声强度和药物载荷均显著增加ALBC的药物释放。体内条件下超声组药物释放量在术后1d和5d分别较对照组高148.18%(t=3.510,P<0.01)和82.39%(t=2.345,P<0.05),术后4周超声组ALBC药物溶出低于对照组(t=3.697,P<0.01)。结论低频连续型超声能促进和加快ALBC的药物释放。更多还原

【Abstract】 Objective To investigate the effect of low-frequency ultrasound on the release of vancomycin from antibiotic-loaded bone cement (ALBC) and its regularity in vitro and in vivo. Methods ALBC specimens were successfully manufactured for in vitro and in vivo assays. 5% and 10% ALBC specimens were both randomly divided into three groups: the control group, 100 mW/cm2 ultrasound group and 300 mW/cm2 ultrasound group. After immersing in PBS of 40 ml for 8 h, the four ultrasound groups were exposed to a timed local ultrasonic field for 30 min, then the drug cumulative concentrations were observed during a 2.5 h period after exposure and on the 24th hour after immersion. Sixteen healthy New Zealand white rabbits were divided randomly into two groups: the ultrasound group was exposed to a local timed intermittent ultrasound field and the control group not. Samples of drainage fluid and urine were collected at programmed intervals during a 5 d period, and the ALBC specimens were extracted from rabbits four weeks after implantations with all their concentrations measured by fluorescence polarization immunoassay (FPIA). Results After immersing 24 h in vitro, the cumulative concentration of vancomycin additionally increased by 71.77% and 73.62% in 10% 100 mW/cm2 ultrasound group and 300 mW/cm2 group respectively comparing with 10% control group; while increased 13.03% and 23.78% in 5% 100 mW/cm2 and 300 mW/cm2 groups comparing with 5% control group. Furthermore, the total release was positively correlated with the ultrasound intensity (P< 0.05) and the amount of vancomycin loaded in specimens (P< 0.01). The total release of vancomycin increased by 148.18% (P< 0.01) and 82.39% (P< 0.05) in 7.5% specimens during a 1 d period and a 5 d period in vivo, respectively, caused by intermittent 30 min exposures of ultrasound with an intensity of 300 mW/cm2. More decreased residue of vancomycin was detected in the ultrasound group than in the control group four weeks after implantations (P< 0.01). Conclusion Low-frequency low-intensity continuous ultrasound may provide an effective method to enhance and accelerate the vancomycin release of ALBC.更多还原