载银羟基磷灰石抗菌涂层螺钉体内抗菌及成骨性能的实验研究

目的采用银(Ag)作为抗菌剂制备羟基磷灰石(hydroxyapatite,HA)/Ag抗菌涂层,初步探讨其体内抗菌及成骨性能。方法采用真空等离子体喷涂技术在不锈钢外固定螺钉表面制备HA及HA/Ag抗菌涂层(Ag质量百分比为3%)。取成年雄性比格犬18只,体重15～20 kg,制备犬右后肢胫骨骨折模型。根据植入螺钉不同分为两组,分别于胫骨截骨平面远端植入HA/Ag涂层螺钉2枚(实验组,n=18),近端植入HA涂层螺钉2枚(对照组,n=18)。以金黄色葡萄球菌沾染螺钉伤口,通过伤口分级、X线片观察及硬组织切片染色观察钉道感染及涂层螺钉-骨界面情况。结果对照组伤口随时间延长感染程度加重(χ2=13.492,P=0.001),实验组无明显变化(χ2=0.208,P=0.901);术后1、2、3周实验组伤口分级情况均优于对照组,差异均有统计学意义(P<0.05)。术后3周激光扫描共聚焦显微镜观察示,两组涂层螺钉表面均有细菌黏附,对照组以绿色活细菌为主,实验组以红色死细菌为主。术后6周硬组织切片扫描电镜观察,对照组涂层螺钉与骨组织之间形成一明显透明带,实验组涂层螺钉与骨组织之间无明显间隙。对照组和实验组骨结合率分别为76.23%±15.54%和93.42%±5.53%,比较差异有统计学意义(t=8.843,P=0.000)。扫描电镜观察示实验组涂层与骨组织间结合紧密,对照组涂层与骨组织间存有明显空隙。结论 HA/Ag涂层螺钉具有良好的抗菌及成骨性能,能起到预防外固定支架螺钉钉道感染和松动的作用。

In vivo experimental study on antibacterial and osteogenic capabilities of hydroxyapatite antimicrobial coating with silver

Objective To investigate the antibacterial and osteogenic capabilities in vivo of hydroxyapatite(HA)/silver(Ag) coating.Methods HA/Ag coating(Ag quality percentage was 3%) and HA coating were deposited to external fixator Schanz screws.The tibial fracture model was established in right hindlimb of 18 adult male Beagle dogs(weighing 15-20 kg).The tibia was stabilized with an external fixator and 2 Schanz screws of HA coating at proximal tibia(control group,n=18) and HA/Ag coating at distal tibia(experimental...