rhBMP-2、PRF和自体骨分别复合珊瑚羟基磷灰石成骨效能的比较研究

目的：通过建立动物骨缺损模型，比较重组人骨形成蛋白-2（rhBMP-2）与珊瑚羟基磷灰石（CHA）复合物、富血小板纤维蛋白（PRF）与珊瑚羟基磷灰石复合物、自体骨与珊瑚羟基磷灰石复合物以及单纯珊瑚羟基磷灰石这四种骨移植材料在骨缺损中的成骨效能。方法：在比格犬双侧胫骨干骺端制备四个相同的骨缺损区，在缺损区分别植入rhBMP-2/CHA、 PRF/CHA、自体骨/CHA及CHA （对照）；3个月后处死动物，行大体标本观察；拍牙科CT，观察各植骨区骨密度情况；制作石蜡切片、 HE染色，比较各植骨区骨组织学特点及新骨形成量。结果：大体标本见四组骨缺损间隙均完全关闭。 X线示自体骨/CHA组和PRF/CHA组骨密度较致密， rhBMP-2/CHA组致密性低于前两者， CHA组未见明显骨致密影。 HE切片见四组新生骨与宿主骨连接紧密，新生骨小梁不规则，粗细不一，排列无序；复合型骨移植材料的新生骨小梁比对照组更密集、粗大，连续性更好；四组植骨区成骨量比较：自体骨/CHA组〉PRF/CHA组〉rhBMP-2/CHA组〉CHA组。结论：复合型骨移植材料成骨效应明显优于单纯珊瑚羟基磷灰石；三种复合型材料中自体骨/CHA成骨效应最好，其次为PRF/CHA， rhBMP-2/CHA最差。

The contrastive research on the osteogenesis effects of recombinant human bone morphogenetic protein-2, platelet-rich fibrin and autologous bone compositeding with coralline hydroxyapatite respectively

Objective： By establishing bone defects animal model, the osteogenesis effects of four groups bone transplantation materials that they are compound of reco mbinant human bone morphogenetic protein-2 （rhBMP -2）, coralline hydroxyapatite （CHA）, compound of platelet -rich fibrin and coralline hydroxyapatite, compound of autologous bone and coralline hydroxyapatite and pure coralline hydroxyapatite were compared by repairing bone defects. Methods： Four same bone defects were prepared on each side of tibial metaphyseal of Beagles , rhBMP-2/CHA, PRF/CHA, autologous bone/CHA and pure CHA were respectively implanted into the bone defects. The Beagles were executed after three months, using gross specimen and dental CT to compare four groups bone growth in bone graft areas and bone mineral density; and decalcified paraffin section, HE staining were used to compare histological characteristics and osteogenesis quantity of new bones. Results： Gross specimen： the space between bone defects of four graft areas were completely closed. X-ray showed： the bone densities were more dense of autologous bone/CHA group and PRF/CHA group, the next for rhBMP-2/CHA group, and there is no significant dense bone density shadow in CHA group. HE staining showed that new bones and host bones were connected closely, new bone trabecular was irregular, varied, and the arrangement was disorderly; compared with CHA group, new bone trabeculars on bone graft areas of other three groups were more dense, thick, with better consecu- tiveness; osteogenesis quantity on bone graft areas of four groups were compared as following： autologous bone/CHA group〉PRF/CHA group〉rhBMP-2/CHA group〉CHA group. Conclusion： osteogenesis effects of composite bone graft materials were much better than that of coralline hydroxyapatite alone;autologous bone/CHA was the best in the osteogenesis effects of three kinds of composite bone graft materials, and that of PRF/CHA was followed by, rhBMP-2/CHA was the last.