量化比较带蒂筋膜瓣促血管化成骨与膜诱导成骨作用及成骨效果的实验研究

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目的通过量化指标测定,明确带蒂筋膜瓣包裹自体骨髓基质干细胞(BMSC)接种的非细胞型组织工程骨在修复骨缺损各时间段中的主要作用及成骨效果,为临床干预骨缺损的治疗提供依据。方法制作动物骨缺损模型及带蒂筋膜瓣,随机分为A、B、C三组,A组为单纯植入对照组,B组为无蒂筋膜瓣对照组,C组为带蒂筋膜瓣实验组,在第4、8、12、16周进行骨修复区吸光度比测量、骨形态计量分析、交界区和中心区血管图像计量分析,第8、12、16周同时进行放射性核素骨显像检查、腋动脉注入墨汁检查及生物力学测定分析。结果第4、8周时,C组与A组、B组相比较其骨修复区吸光度比值、新生骨小梁面积、再生血管面积和放射性核素骨显像摄取比值明显增多,生物力学强度增加,各项量化指标差异均有统计学意义(P<0.05),表现为早期骨修复过程中血管体积增多对成骨作用是有利的;第12、16周时,三组骨修复区吸光度比测量、新生骨小梁面积和生物力学强度逐渐明显增加,C组仍大于A组、B组,但各组再生血管面积和放射性核素骨显像摄取比值较第8周下降明显,差异有统计学意义(P<0.05),表现为随着时间的推移,成熟骨组织量的增多,血管化作用逐渐减弱,后期膜诱导成骨作用显著。结论带蒂筋膜瓣包裹自体BMSC接种的非细胞型组织工程骨具有构建血管化和膜诱导组织再生双重作用,早期促血管化成骨作用占主导地位,并有助于膜诱导成骨作用,后期膜诱导成骨作用为主,促血管化成骨作用消失,临床适时干预治疗对骨缺损修复有极好作用。 OBJECTIVE: To determine the main effect and osteogenesis effect of non-cell tissue engineered bone graft with autologous bone marrow stromal cells (BMSCs) sequestered with pedicled fascia flap in each period of bone defect through quantification index, Provide the basis for treatment. Methods The model of animal bone defect and pedicle fascia flap were made and randomly divided into three groups: A, B and C, group A as control group, group B as pedicled fascia flap control group, At the 4th, 8th, 12th and 16th week, the rabbits in the experimental group received absorbance ratio measurement, bone morphometric analysis, junction area and central area blood vessel image analysis. At the 8th, 12th and 16th weeks, radionuclide Bone imaging examination, axillary artery inking ink examination and biomechanical analysis. Results At the 4th and 8th week, the absorbance ratio of bone repair area, the ratio of new trabecular area, regenerated blood vessel area and radionuclide bone imaging increased significantly in group C compared with group A and group B, and the biomechanical strength increased (P <0.05). The results showed that the increase of vascular volume during early bone repair was beneficial to osteogenesis. On the 12th and 16th week, the absorbance ratio of three groups , The newborn trabecular area and biomechanical strength gradually increased, C group is still greater than A group, B group, but each group of regenerated vascular area and radionuclide bone imaging uptake ratio decreased significantly compared with the 8th week, the difference was statistically significant Significance (P <0.05), showing that with the passage of time, the amount of mature bone increased, vascularization gradually weakened, the late membrane-induced osteogenesis was significant. Conclusions Acellular fasciocapsular fasciocapsular tissue-engineered bone implanted with autologous BMSC has dual roles of vascularization and membrane-induced tissue regeneration. Early vascularized osteogenesis plays a dominant role and contributes to membrane-induced osteogenesis. In late stage Membrane-induced osteogenesis, vasogenic osteogenic effect disappeared, clinical timely intervention treatment of bone defect repair has an excellent effect.
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