酸性成纤维细胞因子复合部分脱蛋白骨修复兔早期股骨头缺血性坏死的影像学评价

背景：酸性成纤维细胞因子（aFGF）具有较好的促进血管形成的作用以及成骨作用。目的：探讨酸性成纤维细胞因子复合部分脱蛋白骨对兔股骨头缺血性坏死修复的修复作用及X线表现，并与单纯生物衍生骨进行比较。设计、时间及地点：随机对照动物实验，于2008-01~2009-01在南华大学生命科学院完成。材料：健康成年新西兰大白兔24只，双侧股骨头颈交界处开窗，挖除股骨头内约50%松质骨，加用95%酒精灌注30min，建立双侧股骨头坏死骨缺损模型。经脱脂、脱蛋白、部分脱钙和冻干等一系列的物理、化学方法处理后制备生物衍生骨支架材料。酸性成纤维细胞因子复合制备组织工程骨支架材料。方法：按随机数字表法，48髋随机分为A组空白对照组，B组单纯部分脱蛋白骨（PDPB）植入组，C组aFGF/PDPB复合人工骨植入组，并将PDPB、 aFGF/PDPB复合人工骨同期手术植入。主要观察指标：术后分别于2周、4周、8周取材，进行大体标本观察、X线照片。以均值±标准差表示，全部数据采用SPSS13.0 统计软件分析，以α=0.05作为检验标准。结果：A组整个过程都呈低密度影；8周时有2例出现股骨头塌陷，缺损区仍呈X线低密度影。B组2周和4周时植骨区与周围正常清晰可见，8周时1例股骨头X线表现正常，2例缺损区与周围正常骨组织仔细辨别可区分，但已模糊不清。C组4周时移植物与周围正常骨组织界限不清，需仔细辨别才能区分；8周时所有股骨头缺损区与周围正常骨组织融合，与宿主骨界限不清。X线评分结果显示， C组优于A组（p〈0.05），B组和C组之间有差异C组优于B组，但差异无统计学差异（p〉0.05）。结论：aFGF与PDPB复合构建组织工程化人工骨对兔早期股骨头缺血坏死具有较好的修复作用，但与单纯PDPB组比较X线表现差异无统计学意义。

Acidic fibroblast growth factor composited by partially deproteinised bone in repair of early-stage avascular necrosis of the femoral head in rabbits--An imageological evaluation

BACKGROUND： Prior studies have demonstrated that acidic fibroblast growth factor （aFGF） composited by partially deproteinized bone （PDPB） （aFGF/PDPB） well promotes vascularization in animals with early-stage avascular necrosis of the femoral head （ANFH）. OBJECTIVE： To evaluate the repairing effects of aFGF/PDPB on ANFH in rabbits using X-ray examination and to compare the effects with PDPB. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed in the College of Life Science, Nanhua University between January 2008 and January 2009. MATERIALS： Ribs from healthy, adult, New Zealand rabbits were prepared into PDPB by a series of physico-chemical methods including degreasing, deproteinization, partial decalcification, and freeze drying. aFGF diluted with sterile distilled water was composited by PDPB particles to prepare artificial composite bone. METHODS： A bone window was made at the juncture of femoral head and femoral neck bilaterally in 24 healthy, adult, New Zealand rabbits. Rabbit models of bilateral ANFH were established by removing approximately 50% of cancellous bone and perfusion with 95% ethanol. Successful bilateral ANFH models were randomly divided into 3 groups： blank, PDPB, and aFGF/PDPB. PDPB and artificial composite bone were implanted into the PDPB and aFGF/PDPB groups accordingly. The blank group did not receive any implantation. MAIN OUTCOME MEASURES： At 2, 4, and 8 weeks after surgery, specimen tissue was harvested for X-ray examination. RESULTS： In the blank group, low-density shadow appeared through the whole process and it was present in the defect region at 8 weeks; in addition, 2 rabbits exhibited collapse of the femoral head. In the PDPB group, at 2 and 4 weeks, bone grafting region and adjacent normal bone tissue could be clearly seen, and at 8 weeks, X-ray examination showed normal femoral head in 1 rabbit, and bone defect regions could be distinguished, but unclear, from adjacent normal bone tissue after careful discrimination in 2 rabbits. In the aFGF/PDPB group, at 4 weeks, the borderline between implants and adjacent normal tissue was not clear, and it should be carefully distinguished; at 8 weeks, bone defect regions of all femoral head fused with adjacent normal tissue without borderline. X-ray evaluation results demonstrated that aFGF/PDPB group yielded better effects than blank group （P 〈 0.05）, and there was no significant difference between PDPB and aFGF/PDPB groups （P 〉 0.05）. CONCLUSION： X-ray results show that tissue-engineered artificial bone composited by aFGF/PDPB exhibits better effects on repairing early-stage ANFH in rabbits, with presentations resembling to PDPB.