CAJ | 학술논문

目的探讨组织工程化骨修复眼眶骨折缺损的治疗效果.方法体外构建以自体骨髓基质干细胞(BMSC)为种子细胞、可降解吸收的生物材料聚乳酸羟基乙酸聚合物(PLGA)为载体、重组人骨形态发生蛋白2(rhBMP-2)为生长因子的组织工程化骨,将实验动物分为对照组(植入PLGA/rhBMP-2复合物)和实验组(植入组织工程化骨),观察术后1个月、3个月和6个月伤口愈合情况、并发症及眼眶外观、CT影像学和组织学变化.结果术后所有动物伤口愈合良好,无并发症和眼球凹陷.CT三维成像显示术后3个月实验组的缺损范围[(25.1±6.8) mm2]小于对照组[(55.3±7.7)mm2]；术后6个月,实验组的眼眶骨折缺损消失,而对照组仍存在.组织学结果显示,术后1个月即可观察到实验组植入区边缘植入物开始缓慢吸收,少量成骨细胞沿支架长人材料内,而对照组未观察到；术后3个月可见实验组形成条带状新生骨长入将其分割包绕呈交叉排列,材料降解吸收明显高于对照组；术后6个月实验组植人材料完全被降解吸收,同时被新生骨组织取代,植入物与自身骨组织紧密结合,融为一体.而对照组仅部分降解吸收.结论重组人骨形态发生蛋白2修饰的组织工程化骨具有较强的传导成骨和诱导成骨活性,生物相容性好,材料可完全降解,为骨组织取代,对眼眶骨折缺损具有较好的修复效果.
목적 탐토조직공정화골수복안광골절결손적치료효과.방법 체외구건이자체골수기질간세포(BMSC)위충자세포、가강해흡수적생물재료취유산간기을산취합물(PLGA)위재체、중조인골형태발생단백2(rhBMP-2)위생장인자적조직공정화골,장실험동물분위대조조(식입PLGA/rhBMP-2복합물)화실험조(식입조직공정화골),관찰술후1개월、3개월화6개월상구유합정황、병발증급안광외관、CT영상학화조직학변화.결과 술후소유동물상구유합량호,무병발증화안구요함.CT삼유성상현시술후3개월실험조적결손범위[(25.1±6.8) mm2]소우대조조[(55.3±7.7)mm2]；술후6개월,실험조적안광골절결손소실,이대조조잉존재.조직학결과현시,술후1개월즉가관찰도실험조식입구변연식입물개시완만흡수,소량성골세포연지가장인재료내,이대조조미관찰도；술후3개월가견실험조형성조대상신생골장입장기분할포요정교차배렬,재료강해흡수명현고우대조조；술후6개월실험조식인재료완전피강해흡수,동시피신생골조직취대,식입물여자신골조직긴밀결합,융위일체.이대조조부부분강해흡수.결론 중조인골형태발생단백2수식적조직공정화골구유교강적전도성골화유도성골활성,생물상용성호,재료가완전강해,위골조직취대,대안광골절결손구유교호적수복효과.
Objective To study the efficiency of tissue engineered bone modified by recombinant human bone morphogenetic protein 2 (rhBMP-2) in reconstruction of orbital fracture.Methods Tissue engineered bone was established in vitro by using antologous bone marrow stromal cells as daughter cells,degradable absorbable biomaterial PLGA as vector and rhBMP-2 as growth factor.The laboratory animals were divided into control group (implanted with PLGA/rhBMP-2) and experimental group (implanted with tissue engineered bone).Wound healing,complications,orbit appearance,CT imaging and histological changes were observed at one,three and six months later after the surgery.Results All the animals were with well healed wounds.Neither complications nor enophthalmus was observed.The 3-D CT scan showed that orbital floor defect scope was smaller [ (25.1±6.8)mm2 vs (55.3±7.7)mm2] and CT values was higher in experiment group at 3 months later than in controls.Six months later after operation,the bone defect disappeared in experimental group but still existed in the controls.Marginal absorption of implanted bone with a small number of osteoblasts penetrating along the stent into the biomaterial was noted in the experimental group as early as one month later after operation,but not in the controls.At 3 months later,the experimental group showed strips of newly formed bone growing into or encapsulating the biomaterial,intersecting with each other and grew,with greater level of biomaterial degradation as compared with controls.At 6 months later,the implanted materials in experimental group were totally absorbed,replaced by newly formed osseous tissues,or fused perfectly with.inherent bone tissue.In contrast,the implants in controls showed only partial degradation and absorbance.Conclusions The tissue engineered bone modified by human bone morphogenetic protein 2 may well conduct and induce the activity of bone formation.Good biocompatibility and total degradability indicate that the implant is efficient in reconstruction of orbital fracture defects.