【作者】 张建政；

【导师】 李亚非；

【作者基本信息】 中国人民解放军军医进修学院 ， 外科学， 2004， 硕士

【摘要】 目的 骨缺损的修复一直是骨科棘手的难题之一，寻找理想的骨修复材料是骨科领域长期以来研究的重要课题。异种骨在来源、韧性、功能适应症、理化性能、空间结构等方面优于其它植骨材料，但新鲜异种骨主要问题是生物相容性极差，有强烈的免疫排斥反应。通过建立大鼠肌袋实验检测受体免疫原性和测试保鲜异种骨抗压强度，判断胡杰教授发明“脱细胞保鲜异种骨”的生物相容性和理学强度以及与BCB的比较。 方法 制备新鲜骨、BCB、保鲜骨骨条，力学实验机分别测量各自的抗压强度，并进行统计学分析。以大鼠为动物模型，分别植入新鲜骨、BCB、以及北京生物组织工程科技有限公司制备的大块保鲜牛皮质骨、松质骨。建立鼠股后肌袋实验，于1、4、12周分别取材，采用体外淋巴细胞二次刺激增殖实验，酶联免疫吸附实验及组织学观察，研究移植后大鼠体内的细胞免疫、体液免疫及宿主对该处理骨移植物的局部病理反应。 结果 保鲜骨的制备过程对生物力学强度无显著性影响，BCB与新鲜松质骨与保鲜松质骨相比较，具有显著性差异。新鲜骨植入后1周，产生高浓度的特异性抗体，并持续到12周，特异性的IgG是实验组的3-7倍；细胞免疫SI值显著升高，4周时特异性T细胞转化率为13％-21％，12周时略有下降，但明显高于其他植入组。组织学检查，新鲜骨各个时间点都有大量的淋巴细胞浸润，具有严重的组织排斥反军医进修学院硕士毕业论文应。保鲜松质骨、皮质骨和BCB杭体呈现低滴度，虽时间延长滴度逐渐降低。尤其松质骨和BCB淋巴细胞刺激指数接近1。组织学显示松质骨和BCB植入体内后，大量的纤维组织长入骨小梁中，具有良好的组织相容性。保鲜牛皮质骨、松质骨显著降低了异种骨的抗原性，其中保鲜松质骨尤佳，与BCB相比较，没有统计学差异。 结论保鲜牛皮质骨、松质骨是一种来源广泛，免疫原性低、力学强度高的植骨材料。与BCB相比较，保鲜骨有效去除引起免疫排斥反应的血液成分和细胞成分，大大消弱移植排斥反应。处理过程相对温和，不损伤胶原结构，矿物质损失很少，可以最大限度保持移植骨的生物学和力学特性，有利于移植区域骨缺损的支撑强度。同时由于保鲜骨创新的异种骨脱杭原方法，从根本改变了以往异种骨处理采用的氯仿、甲醇、乙醚、双氧水等毒性物质，避免了毒性物质残留人体应用时的局部和全身反应问题。更多还原

【Abstract】 Objective Large skeletal repair is always a tough problem perplexing surgeons. The bone graft substitutes play an important role in repairing bone defects, so the search for ideal bone graft substitute to repair bone defects is always an important subject in orthopaedics. Xenogeneic bone graftion is an altermative to autogeneic bone grafting, but the intense immune rejection makes its clinical practicelimited. the author implanted Preserved bovine cancellous bone, Preserved bovine cortical bone, Fresh bovine cancellous and Antigen-extracted bovine cancellous bone carrier in rat muscle pouch to investigate how about the immune rejection of Preserved bovine bone.at the same time.the author studied the compressive strength of all kinds of bone abovely.methods We performed lymphocytes proliferation assay, enzume-linked immunosorbent assay, and histological observation to evaluate the levels of cellular and humoral immunity, and the tissue reaction to the grafting of Wister rat receiving frech boving cancellous bone(FCB), Antigen-extracted bovine cancellous bone carrier(BCB), Preserved bovine cancellous bone(PBCCB) and Preserved bovine cortical bone(PBCTB), while nothing implantion was kept untreated as a control. After implantation ,we harvested at 1, 4, 12weeks. The biomechanics properties of all kinds of bone were evaluated by biomechanics testing instrument. Results Biomechanics test result showed that there was significant differemce inboth BCB and FCB and PBCB. Lymphocyte proliferation was increased in an early phase of the grafting and persisted for a long period in FCB group. Meanwhine higher levels of specific antibody production were not ascended and no appreciable histologic signs of immune or foreign body reaction both in BCB and PBCB groups. The results suggested that BCB and PBCCB were characterized less antigenicity and can be used as osteoconductive material of bone growth factors. Conclusion All the results suggested that PBCCB might be an ideal replacement material for bone transplantation, and might be used effectively as a kind of carrier of BMP. however ,its biomechanics intensity and how to combined with an approperiate dose of the BMPs needed further improving.更多还原