抗结核骨组织工程复合体局部治疗兔脊柱结核的对比研究

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摘要目的探讨以羟基磷灰石与/β-磷酸三钙(hydroxyapatite and/β-tricalcium phosphate，HA/β-TCP)复合体材料及同种异体骨为支架材料构建的抗结核性骨组织工程复合体，评价两种不同抗结核骨组织复合体治疗兔脊柱结核的效果。方法取3月龄经造模成功后的新西兰大白兔36只，行病灶清除术，随机分为3组，每组12只，A组于骨缺损处植入利福喷丁微球-rADSCs/HA/β-TCP抗结核骨组织工程复合体，B组于骨缺损处植入利福喷丁微球-rADSCs/同种异体骨抗结核骨组织工程复合体，C组清创后未做任何处理。术后4、8、12周行影像学(DR)检查，术后第12周将实验动物处死，取标本，行大体观察、组织病理学观察骨缺损修复情况。结果大体观察发现A组骨缺损区被新生骨组织取代；B组骨缺损基本修复，周边可见大量骨组织形成；C组骨缺损处有少量骨组织形成，可见大量纤维组织覆盖。X线观察发现：4周时，A组骨缺损区可见少量骨痂形成，材料与周围骨组织紧密接触。B组骨缺损区可见骨痂形成，C组骨缺损区界限清晰，可见片状低密度影。8周时，A组骨缺损区明显缩小，材料吸收，边界稍模糊。B组骨缺损区可见片絮状高密度影，C组骨缺损区可见点状钙化影。12周时，A组骨缺损区材料基本吸收，B组骨缺损材料部分吸收，椎间隙部分融合，C组骨缺损区界线尚清，椎间隙破坏缺损。组织病理学检查发现：术后12周，A组材料吸收明显，可见大量纤维骨痂组织生成骨组织。B组可见部分同种异体骨残留，周边可见大量纤维骨痂组织生成骨组织。C组可见大量纤维组织形成。结论利福喷丁微球-rADSCs/HA/β-TCP构建的抗结核骨组织工程复合体具有良好的生物相容性，能够有效填充兔腰椎结核病灶清除术后的骨缺损。

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关键词 ：脂肪干细胞, 利福喷丁微球, 羟基磷灰石与/β-磷酸三钙, 复合体, 骨缺损

Abstract：Objective To explore the antitubercular bone engineering composite constructed with hydroxyapatite and / β-tricalcium phosphate (HA / β-TCP) composite material and allogenic bone as scaffolds，and to evaluate the effect of two different anti-tubercular bone tissues Complex treatment of spinal tuberculosis in rabbits.Methods Thirty-six New Zealand white rabbits were selected at the age of 3 months and were divided into 3 groups at random.The rabbits in group A were implanted with Rifapentin microspheres-rADSCs /HA / β-TCP anti-TB bone In the tissue engineering complex，group B received Rifapentin microspheres-rADSCs / allogeneic bone antitubercular bone tissue engineering complex at the bone defect.Group C was not treated after debridement.At 4，8 and 12 weeks after operation，the imaging examination (DR) was performed.At the 12th week after operation，the experimental animals were sacrificed and the specimens were taken for general observation.Histopathology was used to observe the repair of bone defects.Results It was found that bone defect in group A was replaced by new bone tissue.The bone defect in group B was basically repaired，and a large amount of bone tissue was formed in the periphery.A small amount of bone tissue was formed in group C，with a large amount of fibrous tissue covered.X-ray observation found：4 weeks，A group of bone defects in a small amount of callus visible，the material in close contact with the surrounding bone tissue.In group B，callus formation was observed in the bone defect area，and the demarcation of the bone defect area in group C was clear and the lamellar low-density shadow was seen.At 8 weeks，the bone defect area of Group A was significantly reduced，the material was absorbed，and the boundary was slightly blurred.B group of bone defect can be seen film-like high-density film，C group of bone defects can be seen point-like calcification.At 12 weeks，the material in group A was basically absorbed，the material in group B was partly absorbed，and the intervertebral space was partly fused.The boundary of group C was still clear and the detail of disc space was destroyed. Histopathological examination found：A group of material absorbed significantly after 12 weeks，showing a large number of fibrous callus tissue to generate bone tissue.B group visible part of allogeneic bone residue，visible a large number of fibrous callus tissue to produce bone tissue.C group shows a large number of fibrous tissue formation.Conclusion The antituberculosis bone engineering complex constructed by Rifapentin microspheres-rADSCs / HA / β-TCP has good biocompatibility and can effectively fill the bone defect after the removal of lumbar tuberculosis in rabbits.

Key words： adipose derived stem cells rifapentin microspheres hydroxyapatite and/β-tricalcium phosphate complexus bone defects

基金资助:国家自然科学基金(81360283)
发明专利：利福喷丁缓释微球及其制备方法(ZL2012 1 028122.6)

通讯作者: 宋兴华

作者简介: 王腾飞(1988－ )，男，研究生在读，新疆医科大学第一附属医院骨科中心，830054。

引用本文:

王腾飞，麦麦提艾力·阿不力克木，杨勇，陈江涛，王翀，陶颖，宋兴华 *. 抗结核骨组织工程复合体局部治疗兔脊柱结核的对比研究[J]. 实用骨科杂志, 2018, 24(10): 907-930.
Wang Tengfei，Mamateli·ablikem，Yang Yong，et al. Comparative Study of Topical Treatment of Spinal Tuberculosis in Rabbits with Antituberculosis Bone Tissue Engineering Complex Constructed by Different Materials. sygkzz, 2018, 24(10): 907-930.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2018/V24/I10/907

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