微骨折结合bFGF纤维蛋白胶复合物修复关节软骨缺损的实验研究

目的探讨微骨折结合碱性成纤维细胞生长因子（basic fibroblast growth factor bFGF）与纤维蛋白胶复合物对关节软骨缺损的修复作用。方法选择健康成年新西兰大白兔24只，随机分为A实验组、B对照组、C对照组、D空白对照组，每组6只（12膝），所有兔子均造成股骨髁间窝直径4mm全层软骨缺损。A实验组：软骨缺损区造成微骨折并注入1μg bFGF和0．1ml纤维蛋白胶的混合物；B组：软骨缺损区造成微骨折并注入0．1ml纤维蛋白胶；C组：软骨缺损区注入1μg bFGF和0．1ml纤维蛋白胶的混合物；D组：软骨缺损区注入0．1ml纤维蛋白胶；术后8、12周处死动物取标本每次每组3只（6膝），大体观察膝关节活动度及修复组织与周边组织的结合情况，苏木素一伊红染色和甲苯胺蓝染色观察修复组织的形态。根据Wakitani评分标准测定各组不同时间点标本光镜组织学评分，进行统计学分析。结果术后8、12周大体观察与织学观察结果，实验组关节软骨缺损的再生修复均明显优于对照组，差异具有统计学意义（P〈0．05）。结论微骨折和碱性成纤维细胞生长因子都有促进软骨修复的作用，两者结合起来对软骨再生具有更明显的促进作用。

Experimental Study on Repair of Cartilage Defects with Combined bFGF and Microfracture

Objective To study the effect of bFGF combined with microfracture on repair of articular cartilage defect. Methods 24 New Zealand white rabbits were divided into group A, B, C and D randomly. The 4mm in diamete of full-thickness articular cartilage defects were made on femoral intercondylar fossa in all rabbits. Group A： microfracture was made on the cartilage defect and covered with 1μg bFGF and 0. 1ml fibrin glue. Group B： the same microfracture was made on the cartilage defect and covered with the same dosage of fibrin glue. Group C： the cartilage defect was covered with 1 μg bFGF and 0. lml fibrin glue. Group D： the cartilage defect was covered with 0. lml fibrin glue. The rabbits were killed in 8, 12 weeks postoperatively, and the areas of cartilage defect were examined grossly, microscopically and histological scored. Results The cartilage regeneration in Group A was significantly superior to that in control group, there has a significant difference （P〈0.05）. Conclusion Microfracture combined with bFGF plays an effective role in articular cartilage regeneration.