目的 观察小肠粘膜下层(small intestinal submucosa,SIS)和双相磷酸钙(hydroxyapatite??tricalcium phosphate,HA??TCP)以不同比例制备的复合材料修复兔股骨髁缺损的效果,探讨复合仿生骨组分的合适比例。 方法 分别以SIS和HA/TCP质量比1,0.5,0.25制备复合材料。取36只新西

中国修复重建外科杂志2006年第20卷第11期 1061

论　著

不同比例小肠粘膜下层复合双相磷酸钙修复

骨缺损的组织学研究

马鑫　张长青　张开刚　苏琰

　　【摘　要】　　目的　观察小肠粘膜下层(smallintestinalsubmucosa,SIS)和双相磷酸钙(hydroxyapatite2tricalcium

　方法　phosphate,HA2TCP)以不同比例制备的复合材料修复兔股骨髁缺损的效果,探讨复合仿生骨组分的合适比例。分别以SIS和HA 深10mmTCP质量比1,015,0125制备复合材料。取36只新西兰大白兔,制备双侧股骨髁直径6mm、的骨缺损模型,分别采用按三种比例制备的复合材料修复缺损[SIS HA2TCP(1)、SIS HA2TCP(0.5)及SIS HA2TCP

(0125)组]。术后2、4、8和12周观察三种材料修复骨缺损的大体情况,并采用组织学和图像分析技术评价材料的修复效

果。　结果　组织学观察SIS HA2TCP(1)组在12周有少量新生骨形成,骨缺损未修复。SIS HA2TCP(0.5)组在2周即出现新生骨,4周新生编织骨增多并形成骨小梁融合,8周出现大量小髓腔,12周骨缺损基本修复,并出现大量板层骨。

SIS HA2TCP(0.25)组成骨过程基本与SIS HA2TCP(0.5)组相似。组织学评分,术后各时间点SIS HA2TCP(1)组均低

于另两组(P<0.05),4、8周SIS 12周SIS HA2TCP(0.5)组和SIS HA2TCP(0.25)组差异无统计学意义(P>0.05),2、

12周各组之间差异均有统计HA2TCP(0.5)组优于另两组(P<0105)。在新生骨形成及HA2TCP颗粒降解方面,术后8、

学意义(P<0105),且SIS HA2TCP(1)组明显差于另两组,但SIS HA2TCP(0.5)组优于SIS HA2TCP(0125)组。　结论　SIS与HA2TCP以质量比为015制备的复合材料对骨缺损具有良好的修复作用;0.5的成分比可作为构建复合仿生骨支架材料的参考指标。

【关键词】　　小肠粘膜下层　　双相磷酸钙　　骨缺损中图分类号:R318.03　R681.8　　文献标识码:A

EXPERIMENTALSTUDYONREPAIRINGRABBITFEMORALCONDYLESDEFECTBYSMALLINTESTINALSUBMUCOSAANDHA-TCPCOMPOSITIONSATDIFFERENTRATIOS MAXin,ZHANGChangqing,ZHANGKaigang,etal.DepartmentofOrthopedicSurgery,SixthPeople’sHospitalofShanghaiJiaotongUniversity,Shanghai,200233,P.R.China

Correspondingauthor:ZhangChangqing,E2mail:zhangcq@shtel.net

【Abstract】　　Objective　Tostudyanoptimalratioofsmallintestinalsubmucosa(SIS)and(hydroxyapatite2

tricalciumphosphate,HA2TCP,SIS HA2TCP)compositionsaccordingtotheeffectofSIS HA2TCPcompositionswith

differentratiosonrepairingrabbitfemoralcondyledefect.Methods　Thirty2sixrabbitsweremadeintobonedefect.ThreedifferentratiosofSIS modelsof6mmindiameterand10mmindepthinbothsidesoffemoralcondylesHA2TCPcompositions(w w:1,0.5,0.25)wereimplantedintorabbitfemoralcondyledefect.After2,4,8and12weeksofoperation,therepaireffectwasobservedgrossly.Thehistologicalevaluationswereperformedbyhistologicalscoringsystemandcomputerimaginganalysissystem.Results　TheamountofnewboneformationinSIS HA2TCP(0.5).Histologicalobservation:InSIS groupwasmorethanthatinSIS HA2TCP(1)andSIS HA2TCP(0125)groupsHA2TCP(1)group,fewnewboneformationwasseenandbonedefectwasrepairedinthe12thweek.

InSIS HA2TCP

(015)group,immaturewovenbonewasfoundinthedefectinthe2ndweek;moreimmaturewovenboneappearedandformedtrabeculaeinthe4thweek;theregeneratedbonewasvigorouslygrowingintotheinterspacesoftheimplantedmaterialsinthe8thweek;theimplantedmaterialswasbasicallyreplacedbybonystructureandthelamellarboneappearedinthe12thweek.TheresultsofSIS HA2TCP(0.25)groupweresimilartothatofSIS HA2TCP(0.5)group.ThehistologicalscoringwashigherinSIS HA2TCP(015)andSIS HA2TCP(0125)groupsthanthatinSIS HA2.ThescoringwashigherinSIS TCP(1)group(P<0.05)inthe2nd,4th,8th,and12thweeksHA2TCP(0.5)group

作者单位:上海交通大学附属第六人民医院骨科(上海,200233)

通讯作者:张长青,教授,博士导师,研究方向:股骨头坏死、骨不连及骨修复材料,E2.netmail:zhangcq@shtel