钻孔复合人工骨体内植入成骨的实验研究

目的探索符合临床需要的复合人工骨移植材料。方法以磷酸三钙＋多孔羟基磷灰石 (TCP＋ HA)为载体 ,分为钻孔、未钻孔及空白对照三组。自成年新西兰兔股骨转子部取得骨髓基质细胞进行传代培养，所得骨髓基质细胞再与钙磷陶瓷载体复合培养制成复合人工骨。然后植入兔背部肌肉内，分别于手术后第 2、 4、 8、 12周取材。利用组织学和电子显微镜等方法观察细胞在载体内的生长、复合人工骨植入肌肉内的成骨等情况，以及载体钻孔对细胞长入和成骨的影响。结果电子显微镜观察显示，传代的骨髓基质细胞与载体共同培养生长良好，并可长入钻孔载体内部。大体标本可见，复合人工骨植入后，人工骨与周围肌肉连接，无包膜形成。组织学观察显示，术后第 2周组织和血管长入；术后第 4～ 8周有少量骨形成；术后第 12周板层骨形成。三组均无淋巴细胞浸润。与未钻孔者比较，钻孔人工骨的细胞、组织和血管向中心部位生长速度快，中心部位成骨多且更均匀。结论磷酸三钙＋多孔羟基磷灰石载体具有良好的生物相容性及骨传导性；骨髓基质细胞具有成骨能力；载体钻孔有利于增加新骨形成的速度和数量，使成骨更为均匀。

Osteogenesis of artificial composite bone graft in vivo: an animal experimental study

Objective To find an artificial composite bone graft suitable for clinical use. Methods Calcium phosphate ceramic carriers(TCP＋ HA) were used, and in some of them holes were drilled. Bone marrow cells from New Zealand white rabbits were cultured to obtain stromal cells, which were then cultured with the carriers to make the artificial composite bone graft. It was then implanted into muscular pouch on the back of the rabbits. The carriers were taken out at 2, 4, 8 and 12 weeks after surgery. Electronic and light microscopes were used for the observation of the growth of cells within the carriers, osteogenesis of artificial bone in the muscle pouch and influence of the drilled holes to the growth of the cells and osteogenesis. Results The cells grew well within the pouches as well as into the drilled holes. The artificial bone connected well with the surrounding muscular tissue and no envelope was seen. Histological study showed that tissue and blood vessels grew into the carriers at 2 weeks, osteogenesis was observed at 4 to 8 weeks and laminar bone formed at 12 weeks. No lymphocyte was found. The growth of cells, tissue and blood vessels were faster and more bone formed in the artificial bone with the drilled holes than the artificial boen without the drilled holes. Conclusion Calcium phosphate ceramic carriers showed good biological compatibility and osteoconduction. Marrow stromal cells had the capacity of osteogenesis in vivo. Drilling holes into the carrier can increase osteogenic activity as well as increase the quantity of homogenous osteogenesis.