CAJ | 학술논문

目的观察Ⅰ型胶原-血管内皮生长因子(VEGF)缓释材料对骨-肌腱结合部位损伤愈合的促进作用. 方法建立兔部分髌骨切除模型,将制备的Ⅰ型胶原-VEGF缓释支架材料植入髌骨-髌腱结合部位.72只新西兰大白兔按随机数字表法分为对照组、Ⅰ型胶原组和Ⅰ型胶原-VEGF组,每组24只.术后4,8,12周取材,X线片及组织学检测观察髌骨-髌腱结合部位愈合情况,生物力学检测其愈合质量. 结果 X线片显示,术后4,8,12周对照组新生骨面积分别为(2.1 ±0.6)mm2、(4.1 ±0.3)mm2、(6.6 ±0.6)mm2,Ⅰ型胶原组分别为(4.1 ±0.4)mm2、(12.1 ±0.5) mm2、(13.0±1.2)mm2,Ⅰ型胶原-VEGF组分别为(3.8±0.4)mm2、(11.0±0.5) mm2、(13.1±1.0)mm2,与对照组比较,Ⅰ型胶原组和Ⅰ型胶原-VEGF组各时相点新生骨面积均明显增多(P＜0.05).组织学检测显示,对照组新生骨少,有大量纤维细胞聚集,肌腱纤维排列紊乱;Ⅰ型胶原-VEGF组大量新骨形成,胶原纤维组织排列整齐有序,术后4,8周有大量糖胺多糖表达,以纤维软骨修复为主;Ⅰ型胶原组有大量新骨形成,但肌腱端胶原纤维修复差,术后糖胺多糖表达量少,以纤维修复为主.生物力学结果显示,Ⅰ型胶原组、Ⅰ型胶原-VEGF组及对照组的极限拉应力均随时间的推移而增大,12周极限拉应力均明显大于4,8周;相同时相点极限拉应力比较,Ⅰ型胶原-VEGF组＞Ⅰ型胶原组＞对照组(P＜0.05). 结论 Ⅰ型胶原-VEGF缓释材料能早期提高骨-肌腱结合部位生物力学性能,促进愈合及纤维软骨带的形成.
목적 관찰Ⅰ형효원-혈관내피생장인자(VEGF)완석재료대골-기건결합부위손상유합적촉진작용. 방법 건립토부분빈골절제모형,장제비적Ⅰ형효원-VEGF완석지가재료식입빈골-빈건결합부위.72지신서란대백토안수궤수자표법분위대조조、Ⅰ형효원조화Ⅰ형효원-VEGF조,매조24지.술후4,8,12주취재,X선편급조직학검측관찰빈골-빈건결합부위유합정황,생물역학검측기유합질량. 결과 X선편현시,술후4,8,12주대조조신생골면적분별위(2.1 ±0.6)mm2、(4.1 ±0.3)mm2、(6.6 ±0.6)mm2,Ⅰ형효원조분별위(4.1 ±0.4)mm2、(12.1 ±0.5) mm2、(13.0±1.2)mm2,Ⅰ형효원-VEGF조분별위(3.8±0.4)mm2、(11.0±0.5) mm2、(13.1±1.0)mm2,여대조조비교,Ⅰ형효원조화Ⅰ형효원-VEGF조각시상점신생골면적균명현증다(P＜0.05).조직학검측현시,대조조신생골소,유대량섬유세포취집,기건섬유배렬문란;Ⅰ형효원-VEGF조대량신골형성,효원섬유조직배렬정제유서,술후4,8주유대량당알다당표체,이섬유연골수복위주;Ⅰ형효원조유대량신골형성,단기건단효원섬유수복차,술후당알다당표체량소,이섬유수복위주.생물역학결과현시,Ⅰ형효원조、Ⅰ형효원-VEGF조급대조조적겁한랍응력균수시간적추이이증대,12주겁한랍응력균명현대우4,8주;상동시상점겁한랍응력비교,Ⅰ형효원-VEGF조＞Ⅰ형효원조＞대조조(P＜0.05). 결론 Ⅰ형효원-VEGF완석재료능조기제고골-기건결합부위생물역학성능,촉진유합급섬유연골대적형성.
Objective To observe the effect of sustained release type Ⅰ collagen-vascular endothelial growth factor (VEGF) on healing of bone-tendon junction injuries.Methods Partial patellectomy was conducted in 72 rabbits divided equally into control group,type Ⅰ collagen group,and collagen type Ⅰ-VEGF group.The scaffold was planted into the bone-tendon interface.Animals were sacrificed at 4,8 and 12 weeks.New bone formation into the patella-patella tendon surface was detected using X-ray films and histological observations.Quality of bone healing was assayed using biomechanical testing.Results At postoperative 4,8 and 12 weeks,X-ray films showed bone formation of type Ⅰ collagen group [(4.1 ± 0.4) mm2,(12.1 ± 0.5) mm2,(13.0 ± 1.2) mm2 respectively] and of collagen type Ⅰ-VEGF group [(3.8 ± 0.4) mm2,(11.0 ± 0.5) mm2,(13.1 ± 1.0) mm2 respectively] were more than that of control group [(2.1 ± 0.6) mm2,(4.1 ± 0.3) mm2,(6.6 ± 0.6) mm2 respectively] (P ＜ 0.05).Histology identified few new bone,massive fibrocyte accumulation and disrupted alignment of tendon fiber in control group,massive new bone formation,neat and orderly alignment of collagen fiber tissues and massive aggrecan expression at postoperative 4 and 8 weeks (fibrous cartage repair in largely) in collagen type Ⅰ-VEGF group,and massive new bone formation but worse alignment of tendon collagen fibers and less aggrecan expression (fibrous repair in largely) in type Ⅰ collagen group.Biomechanical test showed the ultimate tensile strength increased over time in all groups,with significantly higher value at 12 weeks than that at 4 and 8 weeks.At the same time point,ultimate tensile strength ranged in an order as follows:collagen type Ⅰ-VEGF group ＞ collagen type Ⅰ group ＞ control group (P ＜ 0.05).Conclusion Sustained release type Ⅰ collagen-VEGF can accelerate early healing of bone-tendon junction injury and improve the histological and mechanical properties.