CAJ | 학술논문

背景:研究表明,骨髓间充质干细胞经骨形态发生蛋白诱导可分化为成骨细胞.目的:应用骨髓间充质干细胞、牛骨形态发生蛋白与纤维蛋白胶混合物作为骨移植材料,通过与单纯使用纤维蛋白胶、牛骨形态发生蛋白和骨髓间充质干细胞比较来评价这种移植材料的成骨效果.设计:对比观察实验.单位:广东省第二人民医院,中山大学附属第二医院.材料:实验于2004-01/2006-06在中山大学附属第二医院完成.健康新西兰大白兔由中山大学医学院动物实验中心提供.方法:白兔髂骨抽取骨髓,采用密度梯度离心法在体外培养扩增自体骨髓间充质干细胞.在纤维蛋白胶内加入骨形态发生蛋白制成复合物,再加入骨髓间充质干细胞制成另一种复合物.对12只新西兰大白兔经腹膜外行腰椎间盘切除脊柱融合术.每只动物取L3-6个椎间隙随机接受4种移植方法中的3种:骨髓间充质干细胞+骨形态发牛蛋白+纤维蛋白胶、骨髓间充质干细胞+纤维蛋白胶、骨形态发牛蛋白+纤维蛋白胶、纤维蛋白胶.术后3月利用放射学和组织学方法观察分析脊柱融合情况.主要观察指标:兔脊柱椎间隙骨痂形成情况.结果:①术后12周时,骨髓间充质干细胞+骨形态发生蛋白+纤维蛋白胶组椎间隙骨痂形成明显较其它组多,组织学上有连续的骨痂形成.骨髓间充质干细胞+纤维蛋白胶、骨形态发生蛋白+纤维蛋白胶组可见前纵韧带后方有编织骨形成,骨最少,不连续.纤维蛋白胶组见纤维组织增生及少量成骨细胞,未见新骨形成.各组均未见纤维蛋白胶残留,椎间盘中有少量椎间盘髓核残余、中间有少量软骨组织形成.②12周时X射线检查显示,各组兔均未造成椎体后缘增生,无椎管狭窄.骨髓间充质干细胞+纤维蛋白胶组节段活动度与骨形态发生蛋白+纤维蛋白胶组、纤维蛋白胶组差异显著(P＜0.05);各组间椎体后缘高度丢失差异不显著.结论:自体骨髓间充质干细胞、纤维蛋白胶和骨形态发性蛋白复合体可在椎间关节形成骨性骨痂,融合效果好,组织学方面评价也较其他方法好. 揹景:研究錶明,骨髓間充質榦細胞經骨形態髮生蛋白誘導可分化為成骨細胞.目的:應用骨髓間充質榦細胞、牛骨形態髮生蛋白與纖維蛋白膠混閤物作為骨移植材料,通過與單純使用纖維蛋白膠、牛骨形態髮生蛋白和骨髓間充質榦細胞比較來評價這種移植材料的成骨效果.設計:對比觀察實驗.單位:廣東省第二人民醫院,中山大學附屬第二醫院.材料:實驗于2004-01/2006-06在中山大學附屬第二醫院完成.健康新西蘭大白兔由中山大學醫學院動物實驗中心提供.方法:白兔髂骨抽取骨髓,採用密度梯度離心法在體外培養擴增自體骨髓間充質榦細胞.在纖維蛋白膠內加入骨形態髮生蛋白製成複閤物,再加入骨髓間充質榦細胞製成另一種複閤物.對12隻新西蘭大白兔經腹膜外行腰椎間盤切除脊柱融閤術.每隻動物取L3-6箇椎間隙隨機接受4種移植方法中的3種:骨髓間充質榦細胞+骨形態髮牛蛋白+纖維蛋白膠、骨髓間充質榦細胞+纖維蛋白膠、骨形態髮牛蛋白+纖維蛋白膠、纖維蛋白膠.術後3月利用放射學和組織學方法觀察分析脊柱融閤情況.主要觀察指標:兔脊柱椎間隙骨痂形成情況.結果:①術後12週時,骨髓間充質榦細胞+骨形態髮生蛋白+纖維蛋白膠組椎間隙骨痂形成明顯較其它組多,組織學上有連續的骨痂形成.骨髓間充質榦細胞+纖維蛋白膠、骨形態髮生蛋白+纖維蛋白膠組可見前縱韌帶後方有編織骨形成,骨最少,不連續.纖維蛋白膠組見纖維組織增生及少量成骨細胞,未見新骨形成.各組均未見纖維蛋白膠殘留,椎間盤中有少量椎間盤髓覈殘餘、中間有少量軟骨組織形成.②12週時X射線檢查顯示,各組兔均未造成椎體後緣增生,無椎管狹窄.骨髓間充質榦細胞+纖維蛋白膠組節段活動度與骨形態髮生蛋白+纖維蛋白膠組、纖維蛋白膠組差異顯著(P＜0.05);各組間椎體後緣高度丟失差異不顯著.結論:自體骨髓間充質榦細胞、纖維蛋白膠和骨形態髮性蛋白複閤體可在椎間關節形成骨性骨痂,融閤效果好,組織學方麵評價也較其他方法好.
배경:연구표명,골수간충질간세포경골형태발생단백유도가분화위성골세포.목적:응용골수간충질간세포、우골형태발생단백여섬유단백효혼합물작위골이식재료,통과여단순사용섬유단백효、우골형태발생단백화골수간충질간세포비교래평개저충이식재료적성골효과.설계:대비관찰실험.단위:광동성제이인민의원,중산대학부속제이의원.재료:실험우2004-01/2006-06재중산대학부속제이의원완성.건강신서란대백토유중산대학의학원동물실험중심제공.방법:백토가골추취골수,채용밀도제도리심법재체외배양확증자체골수간충질간세포.재섬유단백효내가입골형태발생단백제성복합물,재가입골수간충질간세포제성령일충복합물.대12지신서란대백토경복막외행요추간반절제척주융합술.매지동물취L3-6개추간극수궤접수4충이식방법중적3충:골수간충질간세포+골형태발우단백+섬유단백효、골수간충질간세포+섬유단백효、골형태발우단백+섬유단백효、섬유단백효.술후3월이용방사학화조직학방법관찰분석척주융합정황.주요관찰지표:토척주추간극골가형성정황.결과:①술후12주시,골수간충질간세포+골형태발생단백+섬유단백효조추간극골가형성명현교기타조다,조직학상유련속적골가형성.골수간충질간세포+섬유단백효、골형태발생단백+섬유단백효조가견전종인대후방유편직골형성,골최소,불련속.섬유단백효조견섬유조직증생급소량성골세포,미견신골형성.각조균미견섬유단백효잔류,추간반중유소량추간반수핵잔여、중간유소량연골조직형성.②12주시X사선검사현시,각조토균미조성추체후연증생,무추관협착.골수간충질간세포+섬유단백효조절단활동도여골형태발생단백+섬유단백효조、섬유단백효조차이현저(P＜0.05);각조간추체후연고도주실차이불현저.결론:자체골수간충질간세포、섬유단백효화골형태발성단백복합체가재추간관절형성골성골가,융합효과호,조직학방면평개야교기타방법호.
BACKGROUND: Several studies have demonstrated that bone marrow mcscnchymal stem cells (MSCs) can differentiate into osteoblasts after induction of bone morphogenetic protein (BMP).OBJECTIVE: This study was designed to compare the osteogenetic effects between MSCs, bBMP, and fibrin gel alone and their composite.DESIGN: A controlled observation experiment.SETTING: Second People's Hospital of Guangdong Province and Second Hospital Affiliated to Sun Yat-sen University.MATERIALS: This study was performed at the Second Hospital Affiliated to Sun Yat-sen University between January 2004 and June 2006. Healthy New Zealand rabbits were provided by the Laboratory Animal Center, Sun Yat-sen University.METHODS: Bone marrow was taken from the lilac bone. By density gradient centrifugation, autologous MSCs were in vitro cultured and amplified. A composite was made of fibrin gel and bovine bone morphogenetic protein (bBMP). After adding MSCs, another composite was made. Twelve rabbits underwent lumbar L3/4, LA/5, and LS/6 discectomy and interbody fusion via an anterior retroperitoneal approach. Three fusion sites in each animal were randomly assigned into three of four treatments: composite of MSCs and hBMP and fibrin gel (group A), composite of MSCs and fibrin gel (group B), composite of bBMP and fibrin gel (group C) and fibrin gel alone (group D). The interbodies were observed radiologically and histologically 3 months after surgery.MAIN OUTCOME MEASURES: Bone formation in the spinal interveRebral space of rabbits.RESULTS: Twelve weeks after surgery, bone formation was appasenfly greater in the Group A than in the other groups.Histological findings revealed continuous bone formation. The groups B and C showed equivalent radiological and histological changes. Bone formation was intermittent. Group D had fibrous union, but no bone formation. No residual fibrin gel was found in all groups, but a small amount of residual nucleus gelatinosus with a little cartilaginous tissue was visible in the intervertebral disc.X-ray examination results did not reveal vertebral posterior hyperplasia or spinal stenosis. There was significant difference in range of lumbar motion between the group B and the groups C and D (P ＜ 0.05). No pronounced difference in vertebral posterior height loss existed among the groups.CONCLUSION: The composite of MSCs, fibrin gel and bBMP can promote bone regeneration and achieve osseous spinal fusion.