骨髓基质细胞移植修复半月板无血运区损伤的实验研究

目的比较自体与同种异体骨髓基质细胞移植对半月板无血运区损伤修复的影响。方法 40只成年新西兰大白兔随机平均分为 A、 B两组。 A组兔的骨髓基质细胞 (MSC)经体外培养后与纤维蛋白凝胶 (FG)混合，自体移植于其一侧的膝关节半月板缺损区，即 FG＋自体 MSC（自体移植组）；另一侧单纯植入 FG(FG植入组 )。于 B组兔的一侧膝关节半月板缺损区移植 FG＋同种异体 MSC(异体移植组 )，另一侧缺损不予修复 (空白对照组 )。分别于术后第 1、 2、 3个月取材，观察半月板损伤部位的组织形态学变化。结果 (1)自体移植组 :术后 1个月缺损区可见纤维组织，内有大量成纤维细胞；术后 2个月见大量软骨细胞并有胶原纤维形成；术后 3个月损伤区呈纤维软骨愈合。 (2)空白对照组 :术后 1～ 3个月缺损区始终未愈合。 (3)单纯 FG植入组 :术后 1～ 3个月缺损区可见纤维组织，内有少量成纤维细胞，没有软骨细胞生长，呈瘢痕样愈合。 (4)同种异体移植组 :与自体移植组所见大致相同，但有 3侧缺损区可见大量淋巴细胞浸润，胶原纤维少。结论骨髓基质细胞移植可促进半月板无血运区损伤的愈合，同种异体骨髓基质细胞移植修复半月板无血运区损伤发生免疫排斥反应的机率较低。

Meniscal repair in the avascular zone with transplantation of bone marrow stromal cells: an experimental study

Objective To compare the influence of autologous- and allogenic- bone marrow stromal cells for repairing meniscal injury in avascular zone. Methods Forty New Zealand white rabbits were evenly divided into group A and B. The bone marrow stromal cells from group A rabbits were cultured and mixed with fibrin glue, forming graft. In group A, the graft was implanted into the meniscal injury zone in one side of the knees(autograft group), and only fibrin glue in another side(fibrin glue group). In group B, the graft was implanted into one side of knees (allograft group), and nothing was implanted into contralateral knees(control group). The rabbits were sacrificed 1, 2 and 3 months after surgery, and morphological study was done. Results In the autograft group, fibrous tissue containing a great deal of fibroblast appeared in the injured zone after 1 month, a large number of chondrocytes with formation of collagens were seen after 2 months, and the injuries healed up with fibrous cartilage after 3 months. In the control group, no healing was seen until 3 months. In the fibrin glue group, fibrous tissue was seen with a few fibroblasts, forming scar healing, but no chondrocyte. In the allograft group, the morphological appearance was similar with the autograft group. However, a large number of lymphocytes were seen in reparative tissue. Conclusion Transplantation of bone marrow stromal cells can promote the healing of meniscal injury in avascular zone. Though the allograft of bone marrow stromal cells may induce rejection, its occurrence rate is lower. The allograft for repairing the meniscal injury is worthy of further study.