CAJ | 학술논문

目的：评价人骨形态发生蛋白（hBMP）-2/骨髓间充质干细胞（BMSCs）/脱钙松质骨（DBM）对兔股骨头坏死的修复作用，探索临床治疗股骨头坏死的新途径。方法髓芯减压联合液氮冰冻法制备兔股骨头坏死模型。将造模成功兔随机分为A、B、C、D 4组(n=12)，A组不植入材料，为对照组，B、C、D分别植入DBM、DBM/BMSCs、hBMP-2/BMSCs/DBM。术后4、8及12周各组分别处死4只，运用X线技术、大体标本观察、HE染色技术评判股骨头坏死修复情况。结果 X线示A组股骨头塌陷，无明显成骨；B、C、D组股骨头缺损区有骨再生现象，但D组再生情况明显优于B、C组。Lane-Sandhu X线评分A组<B、C组<D组（P<0.05），B和C组差异无统计学意义。大体观示A组股骨头塌陷，钻孔存在；B、C组股骨头未塌陷，钻孔存在；D组股骨头未塌陷，钻孔消失。HE染色示A组骨小梁坏死、碎裂，大量空骨陷窝；B、C组可见成骨细胞及新生幼稚骨小梁；D组大量骨细胞，新生骨小梁与正常骨小梁无异。空骨陷窝率A组>B、C组>D组（P<0.05)，B和C组差异无统计学意义。结论 hBMP-2/BMSCs/DBM植入体内后能够诱导BMSCs向成骨方向分化，对兔股骨头坏死具有较好的修复效果。
목적：평개인골형태발생단백（hBMP）-2/골수간충질간세포（BMSCs）/탈개송질골（DBM）대토고골두배사적수복작용，탐색림상치료고골두배사적신도경。방법수심감압연합액담빙동법제비토고골두배사모형。장조모성공토수궤분위A、B、C、D 4조(n=12)，A조불식입재료，위대조조，B、C、D분별식입DBM、DBM/BMSCs、hBMP-2/BMSCs/DBM。술후4、8급12주각조분별처사4지，운용X선기술、대체표본관찰、HE염색기술평판고골두배사수복정황。결과 X선시A조고골두탑함，무명현성골；B、C、D조고골두결손구유골재생현상，단D조재생정황명현우우B、C조。Lane-Sandhu X선평분A조<B、C조<D조（P<0.05），B화C조차이무통계학의의。대체관시A조고골두탑함，찬공존재；B、C조고골두미탑함，찬공존재；D조고골두미탑함，찬공소실。HE염색시A조골소량배사、쇄렬，대량공골함와；B、C조가견성골세포급신생유치골소량；D조대량골세포，신생골소량여정상골소량무이。공골함와솔A조>B、C조>D조（P<0.05)，B화C조차이무통계학의의。결론 hBMP-2/BMSCs/DBM식입체내후능구유도BMSCs향성골방향분화，대토고골두배사구유교호적수복효과。
Objective To evaluate the effect of human bone morphogenetic protein 2 (hBMP-2)/Bone Mesenchymal Stem Cells (BMSCs)/demineralized bone matrix(DBM) on repairing rabbits’femoral head after necrosis and to explore the new treatments for femoral head necrosis. Methods Femoral head necrosis models was established by clinical core decom?pression combined with liquid nitrogen frozen. Then, animals were randomly devided into 4 groups (n=12 per group):Group A were not implanted anything as control group, Group B were implanted with DBM. Group C were implanted with hBMP-2/DBM. Group D were implanted with hBMP-2/BMSCs/DBM. Four rabbits from each group were sacrificed at 4,8 and 12 weeks after surgery to evaluate the the repairing effect of Osteonecrosis of the femoral head (ONFH) through X-ray examina?tion, observation of the specimen and HE staining. Results X-ray revealed defect of femoral head in Group A without clear bone formation. There is a little fibrous hyperplasia and no obvious osteogenic response. By contrast, the femoral head defect areas became fuzzy in group B, group C and group D with new bone trabeculars. And the regenerate phenomenons of group D were significantly better than that of group B and group C of the same time point. As to the Lane-Sandhu X Ray scores, it is lower in group A than that in group B;It is lower in group C than that in group D(P<0.05). There is no statistical difference between Group B and Group C. General observation of the specimen revealed that the femoral head of group A collapsed with drilling holes. The femoral heads of group B and group C showed no collapse but the drilling holes existed. Femoral head in group D was not collapsed and the drilling holes disappeared. HE staining showed that bone trabeculars became ne?crotic and fragmented in Group A with a lot of air trapped cells. There were newborn immature bone trabeculars and osteo? blasts in group B and group C. Group D were of large number of bone cells, fat cells, and newborn mature bone trabeculars. The ratio of empty lacuna is higher in Group A than that in Group B;it is higher in Group C than that in Group D(P<0.05). Conclusion hBMP-2/BMSCs/DBM can induce BMSCs differentiation into osteoblasts after being implanted. It has good re?pairing effect on ONFH with good application prospect.