CAJ | 학술논문

背景：微骨折术方法简单，操作方便，是治疗关节软骨缺损有效的方法之一，但仍然存在再生软骨为纤维软骨、再生软骨退化等问题。现在学者们主要致力于使用各种方法改良微骨折修复软骨缺损的效果。 　　目的：探索微骨折处理软骨缺损区域后植入自体骨髓间充质干细胞外基质支架治疗猪膝关节软骨缺损的疗效。 　　方法：分离并原代培养猪骨髓间充质干细胞，收集其分泌的细胞外基质膜，采用交联、冻干技术将收集的基质膜制备成三维多孔支架。选取小型成年猪，制备双膝股骨髁、股骨滑车部全层软骨缺损模型，深2 mm，直径6 mm；采用自体左右对照模式，右膝作为对照组，使用单纯微骨折治疗软骨缺损，左膝作为实验组，采用微骨折处理软骨缺损区域后，植入预先制备的支架。术后6个月使用番红固绿染色、Masson 染色等评价软骨再生情况，使用Wakitani评分整体评估再生软骨，并测定再生组织糖胺聚糖、DNA含量。 　　结果与结论：术后6个月，实验组股骨滑车和股骨髁处均可见软骨修复，表面光滑，对照组股骨滑车修复组织表面较平整，股骨髁未见明显修复。实验组股骨滑车和股骨髁再生软骨经番红固绿染色、Masson染色均显示软骨层基质含量丰富，软骨下骨骨小梁密集，对照组软骨层染色不明显，软骨下骨修复欠佳。实验组Wakitani评分、糖胺聚糖含量高于对照组，DNA含量低于对照组(P<0.05)。结果可见微骨折结合自体骨髓间充质干细胞外基质支架修复软骨效果良好，股骨滑车和股骨髁治疗效果无显著差异。
배경：미골절술방법간단，조작방편，시치료관절연골결손유효적방법지일，단잉연존재재생연골위섬유연골、재생연골퇴화등문제。현재학자문주요치력우사용각충방법개량미골절수복연골결손적효과。 　　목적：탐색미골절처리연골결손구역후식입자체골수간충질간세포외기질지가치료저슬관절연골결손적료효。 　　방법：분리병원대배양저골수간충질간세포，수집기분비적세포외기질막，채용교련、동간기술장수집적기질막제비성삼유다공지가。선취소형성년저，제비쌍슬고골과、고골활차부전층연골결손모형，심2 mm，직경6 mm；채용자체좌우대조모식，우슬작위대조조，사용단순미골절치료연골결손，좌슬작위실험조，채용미골절처리연골결손구역후，식입예선제비적지가。술후6개월사용번홍고록염색、Masson 염색등평개연골재생정황，사용Wakitani평분정체평고재생연골，병측정재생조직당알취당、DNA함량。 　　결과여결론：술후6개월，실험조고골활차화고골과처균가견연골수복，표면광활，대조조고골활차수복조직표면교평정，고골과미견명현수복。실험조고골활차화고골과재생연골경번홍고록염색、Masson염색균현시연골층기질함량봉부，연골하골골소량밀집，대조조연골층염색불명현，연골하골수복흠가。실험조Wakitani평분、당알취당함량고우대조조，DNA함량저우대조조(P<0.05)。결과가견미골절결합자체골수간충질간세포외기질지가수복연골효과량호，고골활차화고골과치료효과무현저차이。
BACKGROUND:Micro-fracture surgery method is simple, easy to operate, which is an effective way to treat articular cartilage defects, but there are stil some problems such as regenerated fibrocartilage and regenerated cartilage degradation. Scholars have focused on the use of various methods to improve the micro-fracture effect on repairing cartilage defects. OBJECTIVE:To explore the effects of micro-fracture enhanced by autologous bone marrow mesenchymal stem cells extracellular matrix (aBMSC-dECM) scaffold for treating cartilage defects in minipig models. METHODS:Bone marrow was extracted from the minipigs and bone marrow mesenchymal stem cells were obtained. aBMSC-dECM membranes were col ected. Cross-linking and freeze-drying technology were used to make the three-dimensional porous aBMSC-dECM scaffold. Ful thickness cartilage defects, 2 mm in depth and 6 mm in diameter, were created on the femoral condyles and trochlea grooves of the two knees of the minipigs. The right knees were treated with micro-fracture as control and the left were treated with micro-fracture enhanced by aBMSC-dECM scaffold. Six months later, histological examination and Wakitani score were used to evaluate the cartilage regeneration, and glycosaminoglycans and DNA contents in the regenerative tissue were determined. RESULTS AND CONCLUSION:After 6 months, the tissue treated by micro-fracture enhanced by aBMSC-dECM scaffold got better surface and integrated with the surrounding cartilage. Safranin O and fast green staining and Masson staining showed that the regenerated cartilage of the left knee, with abundant matrix and dense bone trabeculae, was better than that of the right. Wakitani score of the left knee was higher than that of the right. Glycosaminoglycans content of the left knee was much more than that of the right, while the DNA content was lower in the left knee than the right knee. Better results were observed in the left knee undergoing micro-fracture enhanced by aBMSC-dECM scaffold, and improvements in the femoral condyles and trochlea grooves showed no differences.