富含血小板血浆＋骨粉在骨缺损修复中的对比研究

目的：探讨天博（珊瑚转化型羟基磷灰石CHA）和Cerasorb（羟基磷酸三钙β-TCP）两种骨粉单独及分别联合富含血小板血浆（PRP）对骨缺损再生修复效果研究。方法：选用15只成年雄性新西兰大白兔,随机分为三组,全麻下在距下颌骨下缘3mm,下颌角前缘5mm处,用球钻制备大小约15mmx6mmx4mm的缺损,左右侧缺损中各植入A PRP CHA＋PRP;B PRPβ-TCP＋PRP;C CHA＋PRPβ-TCP＋PRP;D CHA CHA＋PRP;Eβ-TCPβ-TCP＋PRP,三组兔子分别饲养4周,8周,12周。并在术后第1周,第3周,第5周分别给予钙黄绿素（10mg/kg）,茜素红（30mg/kg）,钙黄绿素（10mg/kg）处死后进行组织切片观察及骨密度测量,分析结果,SPSS17.0统计软件进行统计分析,以P小于0.05为有显著差异性。结果：组织学检查：4周时,PRP组、CHA组及β-TCP组只有极少量的成骨细胞;8周时,少量的新生骨的生成,但仍有大部分的纤维组织包绕;12周时,有部分成熟骨出现;4周时,CHA＋PRP组及β-TCP＋PRP组开始有成骨细胞及少量未成熟的骨质出现;8周时开始有部分成熟骨出现,成骨细胞核固缩多见;12周时已基本充满成熟骨质。在4、8、12周时,X线上骨缺损区密度百分比分析值PRP组、CHA组及β-TCP组之间无显著差异,而β-TCP＋PRP组及CHA＋PRP组的分析值高于上述三组,但该两组间无明显差异。HE染色的骨定量分析,PRP组、CHA组及β-TCP组之间骨再生情况无显著差异,而两混合组的骨再生值高于上述三组,但该两组间的骨再生无显著差异。结论：1.PRP与骨粉联合应用较PRP单独应用对骨缺损再生效果好。2.β-磷酸三钙联合PRP较羟基磷灰石联合PRP应用对骨缺损再生效果无明显差异。3.β-磷酸三钙与PRP联合应用较β-磷酸三钙单独应用对骨缺损再生效果好。

Comparative study of effect of bone restoration of bone defect using platelet rich plasma combined osteo mineral

Objection： To explore the effect of bone regeneration using two different osteo mineral ,CHA andβ-TCP combined with platelet rich plasma ,respectively.Method： Fifteen adult New Zealand white rabbits,male,enough old ,were divided three groups randomly ,five rabbits（marked by A、B、C、D、E）,included in each group,At the same time,4CM incision was done at the inferior margin of mandible and mucosa 、muscular layer and bone was exposed,but the periosteum was conserved .15mmX6mmX4mm bone defect was prepared about 5mm before angle of mandible and 3mm above inferior margin of mandible using round bur .We put the osteo mineral according to the design A：PRP CHA＋PRP B：PRP β-TCP ＋PRP C：CHA＋PRP β-TCP D：CHA CHA＋PRP E： β-TCPβ-TCP＋PRP in the left and right bone defect of each rabbit.At the 1week、3week、5week,calcein（10mg/kg）,alizarin（30mg/kg）,calcein（10mg/kg） was injected under fur skin of its cervical part,respectively.After 4week、8week、12week,5 rabbits was sacrificed by injecting air to the vein in the ear,respectively.Then the jaw we needed was taken to investigate by X-ray ,histology of HE staining and sclerous tissues blade fluorescence microscope to compare the bone regeneration.And then we analysis the results with SPSS,and it’s utility if P〈0.05.Result： The observation of histology indicated that at 4week ,the area of bone defect of the group of PRP 、Tianbo and Cerasorb existed many fibrous tissue and infl.Cells ,just had thimbleful osteoblast;at 8week,although the area of bone defect have little newly formed bone ,also many fibrous tissue and Haversian System could be found ;At 12week,the area of bone defect had part of mature newly formed bone at 4week ,area of bone defect of the group of Tianbo＋PRP and Cerasorb＋PRP have enough blood and can be found osteoblast and a little quantity non-mature bone;at 8week,;the area of bone defect appeared part of mature newly formed bone,most of the area was osteoblast that began to pyknosis;At 12week ,the area of bone defect was full of mature bone.At 4week、8week、12week,the examination of the bone density of bone regeneration indiacted that between the group of PRP 、Tianbo and Cerasorb ,there was no distinguished difference,but the group of Tianbo＋PRP and Cerasorb＋PRP had distinguished difference compared with above three groups .has distinguished difference.The Mean and Standard deviation of each group at different point：.The numerical value of area rate of newly bone ：between the group of PRP ,CHA and β-TCP,there was no distinguished difference,but the value of the group of CHA＋PRP andβ-TCP was higher than the above three groups,and between the two group ,there was no distinguished difference.Conclusion： 1.The effect of bone regeneration using CHA＋PRP and β-TCP＋PRP is better than using PRP .2.The effect of bone regeneration usingβ-TCP＋PRP has no distinguished difference compared with using CHA＋PRP.3.The effect of bone regeneration using β-TCP＋PRP is better than usingβ-TCP.