【作者】 唐周舟；

【导师】 金格勒；

【作者基本信息】 新疆医科大学 ， 外科学， 2009， 硕士

【摘要】 目的:观察重组人骨形态发生蛋白-2/异体骨复合骨(组织工程骨)、自体骨与异体骨用于兔腰椎融合后,不同时间点融合骨组织中内源性BMP-2的基因表达和其微结构的变化。方法:成年雄性新西兰大白兔72只,随机分为3组,每组24只。在每只兔的L5、L6横突间行腰椎后路植骨融合术,各组分别植入复合骨条,自体髂骨条以及单纯异体髂骨条,每组于术后第4天、1、2、3、4、5周各处死4只大白兔,分离保存融合节段标本,每份标本随机选择其中一侧融合骨组织用原位杂交法检测其内源性BMP-2的基因表达,另一侧则用显微CT扫描后行骨组织定量分析。结果:术后6个时间点中,复合骨组BMP-2的表达均要高于自体骨组及异体骨组(P<0.05);在第5周时,自体骨组与异体骨组BMP-2的表达差异无统计学意义(P>0.05)。术后第3、4、5周,复合骨组和自体骨组新生骨小梁的质量和形态均要优于异体骨组且差别有统计学意义(P<0.05)。第3周,复合骨组的组织骨密度(TMD)为(433.98±2.64)mg/cm3,高于自体骨组(424.81±4.69)mg/cm3(P<0.05);第4周,复合骨组的骨小梁厚度(Tb.Th)为(0.097±0.004)mm,高于自体骨组(0.082±0.003)mm(P<0.01);第5周,复合组的组织矿含量(TMC)为(7.70±0.30)mg,高于自体骨组(7.00±0.24)mg(P<0.01)。结论:在兔腰椎后路横突间植骨融合中,rhBMP-2/异体骨复合骨能很好的促进骨组织的形成,其成骨效应不低于自体骨,优于异体骨。更多还原

【Abstract】 Objective: To investigate the endogenous BMP-2 gene expression and the microstructure of fusion masses taken from the rabbits undergone posterolateral lumbar spinal fusion with rhBMP-2/allograft composite, autograft and allograft. Methods: Seventy-two adult male New Zealand white rabbits were randomly divided into three groups: rhBMP-2/allograft composite group, autograft group and allograft group, and each group included 24 rabbits. The rabbits were undergone L5, L6 intertransverse process fusion using rhBMP-2/allograft composite, autogenous iliac crest bone graft and allograft. Every four rabbits from each group sacrificed at the 4 th day and the 1th ,2th ,3th, 4th, 5th week after operation, and the fusion masses were harvested then. One side of each fusion mass was randomly chosen for the use of testing the endogenous BMP-2 gene expression by in situ hybridization, and a high resolution micro CT was used to identify the densimetric and microstructural properties of the other side of the fusion mass. Results: The endogenous BMP-2 gene expression of the composite group was significantly higher than that of autograft group and allograft group at all the six time-points. At the 5th week, there was no significant difference between the autograft group and the allograft group in the endogenous BMP-2 gene expression. Compared with the allograft group at the 3th, 4th, 5th week after operation, there was a significant difference in all parameters in the trabecular bone of the rhBMP-2/allograft composite group and autograft group. At the 3th week, the mean value of Tissue Mineral Density (TMD) in the composite group was (433.98±2.64)mg/cm3, it was significantly higher than that of autograft group(424.81±4.69)mg/cm3. At the 4th week, the mean value of Trabecular Thickness(Tb.Th) in the composite group was(0.097±0.004)mm, it was significantly higher than that of autograft group(0.082±0.003)mm. At the 5th week, the mean value of Tissue Mineral Content(TMC) in the composite group was(7.70±0.30)mg, it was significantly higher than that of autograft group(7.00±0.24)mg. Conclusion: The rhBMP-2/allograft composite was not inferior to autograft and superior to allograft in accelerating and enhancing bone formation in a rabbit posterolateral lumbar spinal fusion model.更多还原