BMP、VEGF复合异种骨修复大段骨缺损的实验研究

目的　探讨骨形态发生蛋白 (BMP)结合血管内皮细胞生长因子 (VEGF)修复兔桡骨大段骨缺损的效果。方法　以聚乙烯吡咯啉酮 (PVP)作为VEGF的可溶性载体 ,以小牛松质骨为固体载体 ,制成小牛松质骨 BMP PVP VEGF、小牛松质骨 PVP BMP、小牛松质骨 PVP VEGF以及小牛松质骨 PVP载体 4种复合物 ,分别植入兔桡骨中段 15mm骨缺损处 ,在术后3,8,12周 ,通过大体解剖、X线片、病理组织切片、生物力学测试等方法观察各组骨愈合、力学强度。结果　在术后 3,8,12周 ,病理组织切片及X线片显示骨缺损修复程度小牛松质骨 BMP PVP VEGF组明显优于其余 3组。生物力学测试显示术后 12周小牛松质骨 BMP PVP VEGF组抗扭转强度明显优于其余 3组 ,近似于正常骨。结论　BMP和VEGF联用有明显促进骨缺损修复的作用 ,效果明显优于单纯应用BMP、VEGF和松质骨载体。

Use of BMP/VEGF in repair of segmental radius defects in rabbits

Objective To investigate the efficacy of combined use of bone morphogenetic protein(BMP) and vascular endothelial growth factor(VEGF) for repairing segmental bone defects. Methods Four kinds of composites: vituline cancellous bone carrier/BMP PVP/VEGF, vituline cancellous bone carrier/PVP/BMP, vituline cancellous bone carrier/PVP/VEGF and cancellous bone PVP were made. Next, the four kinds of composites were implanted respectively in the 15-mm-long continuous defects in radius of adult rabbits. The animals were sacrificed at 3,8 and 12 weeks after operation, and the bone repair process was investigated using physical, X-ray film, histological observation and biology mechanics detection. Results Histological and roentgenographic examination showed that vituline cancellous bone carrier/BMP PVP/VEGF composite repair was more rapid and vigorous, bone density was higher and antibending force was stronger compared with the other 3 groups after 12 weeks. Conclusion The composite of vituline cancellous bone carrier/BMP PVP/VEGF can efficiently repair bone defects, which can improve not only the vascularization but also the differentiation of primitive cells, so it is the best.