骨髓基质干细胞复合同种骨移植治疗创伤性股骨头坏死实验研究

目的探讨骨艇基质干细胞复合同种骨移植在治疗创伤性股骨头坏死中的成骨作用。方法6月龄SD大鼠36只，随机分为模型组、髓芯减压组及复合骨组。每组12只。取4周龄SD大鼠骨髓基质干细胞体外分离培养，取生长状态良好的第三代细胞复合同种骨粉；采用圆韧带离断方法制备大鼠创伤性股骨头坏死动物模型；于术后1、2、4、6周分别处死动物；光镜下观察三组间病理形态学改变；骨形态计量学参数测量及计算新骨生成量，得出骨小梁相对体积（BV／TV）、骨小梁厚度（Tb．Th）、骨小梁数量（Tb．N）、骨小梁分离度（Tb．Sp）。结果成功的复制出大鼠股骨头坏死模型，呈现出典型股骨头坏死不同时期病理改变；术后6周，骨形态计量学参数检测结果：复合骨组新骨生成量均多于模型组及髓芯减压组，其参数BV／TV、Tb．N、Tb．Th、Tb．Sp与其他二组比较差异均有统计学意义（P〈0．05）。结论BMSCs复合同种骨支架可作为“活骨”用于ONFH模型治疗并在其修复中可提高诱导成骨能力及股骨头坏死的骨修复能力，其作用优于单纯髓芯减压。

EXPERIMENTAL STUDY ON BONE MARROW STROMAL STEM CELLS COMPOUND WITH ALLOGENEIC BONE TO REPAIR TRAUMATIC OSTEONECROSIS OF THE FEMORAL HEAD

Objective To explore the osteogenesis effect of bone marrow stromal stem cells （BMSCs） compound with allogeneic bone in treating osteonecrosis of the femoral head. Methods Osteonecrosis of femoral head modal was created by removing round ligaments of femoral head in thirtysix SD rats about six- mouth - old which divided randomly into modal group, core decompression group and BMSCs / allogeneic bone group respectively. 12 animals in each group were sacrificed successively at 1, 2, 4, 6 week postoperatively. The BMSCs were isolated from four- week - old SD rats and cultured in vitro. The 3rd generation of BMSCs were compounded with allogeneic bone. The specimens were examined through histological observation under light microscope. Histomorphometric parameters of new bone formation （including percent trabecular area, BV/TV; Trabecular number, Tb. N; Trabecular thickness, Tb. Th; Trabecular separation, Tb. Sp） was measured by Von Kossa staining undecalcified slices. Results ONFH was confirmed in three groups. At weeks 6, the amount of new bone formation in the BMSCs / allogeneic bone group was greater than that of modal group and core decompression groups. There was significant difference in bone histomorphometric parameters （BV/TV, Tb. Th, Tb. N, Tb. Sp） among three groups at 6 weeks postoperatively （P〈0.05）. Conclusion BMSCs / allogeneic bone can be used in the treatment of ONFH modal as activity bone, which has strong ability of osteoinduction and bone repairing. The therapy effect is greater than that pure core decompression.