重组合异种骨复合bFGF对兔股骨头坏死修复的影响

目的:将吸附有成纤维细胞生长因子(bFGF)的重组合异种骨(RBX)植入病灶清除区,观察组织病理变化过程,评价其诱导成骨活性及生物降解性,以探索治疗股骨头坏死(FHN)的新方法。方法:对以局部液氮冷冻法造成的20只兔FHN模型行病灶清除术,对各股骨头分别采取A、B、C、D四种干预方式(不同的填充物),其中A种方式以复合有bFGF的RBX充填骨腔,分别于术后3、6、12周处死动物,行X线大体标本、组织病理检查及股骨头相对骨密度分析。结果:①X线大体观察:3周时实验组与对照组骨密度均无明显增高;6周时实验组骨密度较对照组高;12周时实验组骨密度接近于正常兔股骨头骨密度,对照组较低。②X线摄片结合计算机相对骨密度分析:3周时实验组与对照组骨密度比较无明显差别,6周、12周时实验组骨密度明显高于对照组(P<0.05)。③组织学观察:3周时所有兔股骨头骨细胞、骨髓细胞、软骨细胞完全坏死,骨小梁完整;6周时实验组钻孔植骨处成骨细胞及毛细血管明显多于对照组;12周时实验组新生骨组织修复已达软骨下,对照组植骨块仍有少量未被吸收。结论:RBX复合bFGF具有明显的诱导成骨及促进血管再生能力,能有效促进坏死股骨头的修复。

Effect of RBX Filled with bFGF on Repairing Process of Femoral Head Necrosis in Rabbit

Objective:To observe the histological changes after RBX filled with bFGF was implanted into the necrotic area of femoral heads in rabbits and to evaluate tis reducing osteogenesis and biodegradation so as to explore a new treatment of femoral head necrosis(FHN).Methods:Femoral head necrosis in 20 rabbits was induced with liquid nitrogen-and these rabbits were treatment with four different interventional options(four different fillers including RBX filled with bFGF)) after epluchage had been performed.In option A,RBX with bFGF was applied to fill the bone defective cavity.The animals were sacrificed 3,6,and 12 weeks later,respectively.X-ray examination,histopathological evaluation and comparative bone density analysis were conducted on the femora.Results:Roentgenographically,bone density was not significantly increased 3 weeks after the operation in the both study and control groups;after 6 weeks bone density was increased greatly in the study group when compared with that in controls and 12 weeks later it was closely to the normal bone density while it was still lowered in control group.X-ray combined with computerd bone density analysis revealed that bone density was not different from that in the controls and it was significantly increased compared with that of the control group(P<0.05).histopathologically,osteocytes,bone marrow cells and chondrocytes were completely necrotic but bone trabecula remained intact after 3 weeks;6 weeks after theoperation,osteocytes and capillaries were increased at the sites of implantation of RBX compared with the control group;after 12 weeks,nascent osseous tissue reached to cartilage in study group;pieces of implanted bone remained unabsorbed in controls.Conclusion:RBX filled with bFGF had a strong activity of osteoinduction and vascularization-promotion capability.Therefore,RBX filled with bFGF could accelerate the repair of necrotic femoral head.