【作者】 唐建军；

【导师】 杨松涛；

【作者基本信息】 成都中医药大学 ， 中医骨伤科学， 2009， 硕士

【摘要】 目的：观察菟丝子多糖—羟基磷灰石复合物局部植入对兔股骨髁部松质骨缺损模型的修复作用。方法：将48只日本大耳白兔双侧股骨髁部进行松质骨缺损造模,造成股骨髁部直径6mm,深10mm的模型后,随机分为3组(实验组／对照组／模型组)：实验组缺损区局部植入菟丝子多糖-HA复合物；对照组缺损区局部植入BMP-HA-明胶复合物；模型组缺损区局部不植入药物。术后8、12周X摄片影像学评分后,取双侧股骨髁部松质骨骨缺损标本行大体观察、组织学观察并且对骨缺损修复面积和骨缺损修复率进行统计,比较3组之间差异。结果：术后影像学评分：8周时术后影像学评分为实验组3.071±0.475,对照组3.143±0.363,模型组1.167±0.389,实验组与对照组比较P>0.05,与模型组比较P<0.01；12周实验组3.571±0.514,对照组3.714±0.469,模型组1.833±0.835,实验组与对照组比较P>0.05,与模型组比较P<0.01。大体观察：8周时,实验组缺损区周围肌肉等软组织轻微肿胀,颜色稍白,无充血水肿,缺损区植入物质地明显变软,明显吸收,股骨髁部骨缺损处有大量新生骨痂由周围向中心生长,骨缺损处新生骨痂与植入物边界模糊；对照组缺损区周围肌肉等软组织情况同实验组,可见植入物少量吸收,但硬度较实验组高,且缺损边缘新生骨痂量少于实验组；模型组缺损区周围肌肉等软组织轻微肿胀,骨缺损处有红色软组织充填,未见明显骨痂生长。12周时,实验组缺损区周围肌肉等软组织肿胀消退,颜色恢复正常,可见缺损区大量骨痂生成并充填,颜色较正常骨组织浅,硬度不及正常骨；对照组缺损区周围肌肉等软组织情况同上,但骨痂量较实验组少；模型组缺损区周围肌肉等软组织无肿胀,无渗出,周围有少量骨痂长出,但已硬化,较大缺损区内白色软组织充填于其中,骨痂与缺损区内软组织边界清楚。骨缺损修复面积：8周时骨缺损修复面积为实验组21.558±0.933,对照组21.749±0.992,模型组17.003±1.423。实验组、对照组与模型组比较有极显著性差异(P<0.01),实验组与对照组比较无显著性差异(P>0.05)；12周实验组25.654±0.662,对照组25.734±0.681,模型组20.543±0.798。实验组与对照组比较无显著性差异(P>0.05),与模型组比较有极显著性差异(P<0.01)。骨缺损修复率：8周时骨缺损修复率为实验组76.283±3.301,对照组76.961±3.509,模型组60.167±5.035。实验组与对照组比较无显著性差异(P>0.05),与模型组比较有极显著性差异(P<0.01)；12周时,实验组90.777±2.341,对照组91.062±2.410,模型组72.694±2.822,实验组与对照组比较无显著性差异(P>0.05),与模型组比较有极显著性差异(P<0.01)。结论：通过8周、12周组织学观察、影像学评分、骨缺损修复面积以及骨缺损修复率结果,表明菟丝子多糖—HA复合物植入对兔股骨髁部松质骨缺损有明显的修复作用,其作用与BMP—HA—明胶复合物一致。更多还原

【Abstract】 Objective:To observe the Cuscuta polysaccharide-hydroxyapatite complex partial implantation of the rabbit femoral condyle defect model of bone repair.Method:The 48 rabbits with bilateral femoral condyle to cancellous bone defect model, resulting in femoral condyle diameter 6mm, after the model of 10mm deep, were randomly divided into 3 groups (experimental group/control group/model group):The experimental group implants partial defect of Cuscuta polysaccharide-HA complex; control group, partial defect in control group implanted BMP-HA-gelatin complex; Model group of local non-implant defect area of drug.8,12 weeks after X ray imaging score after bilateral femoral condyle from bone samples of bone defects in general observation, histological examination and repair of bone defect area and the rate of bone defect repair statistics, observation of 3 groups the difference between.Result:Postoperative imaging score:8 weeks after imaging for the experimental group, score 3.071±0.475, control group,3.143±0.363, model group,1.167±0.389, the experimental group compared with the control group no significant difference, P> 0.05, compared with the model group P<0.001; 12-week experimental group was 3.571±0.514, control group,3.714±0.469, model group,1.833±0.835, the experimental group compared with the control group no significant difference P> 0.05, compared with the model group P<0.001.General observation:8 weeks, the experimental group, such as defects of soft tissue around the muscle slightly swollen, slightly white color, no congestion and edema, defect absorption implants can be seen clearly, and its soft texture obviously shows femoral condyle bone defect there is a large number of new bone callus growth to the Center from around the bone defect with new bone implants fuzzy boundaries; The control group, such as defects of soft tissue around the muscle with the experimental group cases, implants can be seen a small amount of absorption, but the experimental group than the high hardness and the edge of new bone defects less than the experimental group; Model group, such as defects of the muscles around the slight swelling of soft tissue, bone defect filling with red soft tissue, no significant bone growth.12 weeks, the experimental group, such as defects of soft tissue around the muscle swelling subsided, the color returned to normal, we can see a large number of defects generated callus and filling defects, color light than normal bone tissue, bone hardness of less than normal; The control group, such as defects of soft tissue around the muscle the situation with the experimental group, but bone less than the experimental group; Model group, such as defects of soft tissue around the muscle without swelling, without effusion, a small amount of surrounding bone to grow, it has hardened, we can see a larger soft tissue defect in the white area in which filling, and bone and soft tissue defect in the border area clear.Area of bone defect repair:8 weeks to repair bone defect area of the experimental group 21.558±0.933, control group,21.749±0.992, model group,17.003±1.423. Experimental group, the control group compared with the model group has a very significant difference (P<0.001) the experimental group, control group, no significant difference, P> 0.05; 12-week experimental group,25.654±0.662, control group,25.734±0.681, model group,20.543±0.798. Experimental group compared with the control group no significant difference (P> 0.05), compared with the model group P<0.001, a very significant difference.The rate of bone defect repair:8 weeks to repair bone defects in experimental group was 76.283±3.301, control group,76.961±3.509, model group,60.167±5.035. Experimental group compared with the control group no significant difference (P> 0.05), compared with the model group has a very significant difference (P<0.001); 12-week experimental group,90.777±2.341, control group,91.062±2.410, model group,72.694±2.822, Experimental group compared with the control group no significant difference (P> 0.05), compared with the model group has a very significant difference (P<0.001).Conclusion:Through 8 weeks,12 weeks, histological observation and imaging score, bone defect area, as well as the results of bone defect repair rate that Cuscuta polysaccharide-HA complex implantation femoral condyle of rabbit cancellous bone defect repair of a clear role its role with the BMP-HA-gelatin complex line.更多还原