仿生组织工程软骨修复关节软骨损伤的效果及应用超声弹性成像方法检测价值分析

目的体外构建的仿生组织工程软骨修复羊膝关节软骨损伤，通过组织学染色、点压力学分析、超声弹性成像检查来评价修复效果，探讨超声弹性成像方法评估再生软骨质量的可行性。 方法共选用雄性山羊12只，随机分A、B、C三组，A组空白对照组2只，仅做股骨髁负重区直径6 mm全层软骨缺损；B组单纯仿生软骨（ECM）支架修复组4只，在股骨髁负重区软骨缺损处仅植入仿生软骨支架；C组仿生软骨支架复合自体骨髓间充质干细胞（BMSCs）组6只。取自体髂骨骨髓血分离骨髓间充质干细胞培养，细胞浓度达到1×10⁷个/毫升后加入仿生软骨支架中，将构建好的仿生组织工程软骨植入股骨髁软骨缺损中。每组的羊均先在左膝造模，术后3个月再右膝造模，待右膝术后3个月时先行超声弹性成像检查，然后取材行评分，病理染色、糖胺多糖（GAG）含量测定、力学检测分析。 结果3个月和6个月的A组基本无软骨组织修复。在大体评分、病理评分、GAG含量测定、点压力学测试的结果显示C组优于B组（P<0.05），并且B组与C组中的6月数据均明显优于3个月（P<0.05）。其中C组动物6个月取材发现重建软骨更接近正常软骨组织。修复组织大体形态结果，点压力学测试结果与超声弹性成像检查结果对比基本一致。 结论利用组织工程方法构建仿生软骨可治疗早期软骨损伤，复合自体骨髓间充质干细胞的仿生支架能达到更好的修复效果。软骨损伤经过仿生软骨修复后恢复周期在6个月以上。超声弹性成像检查软骨修复效果可作为术后复查简单快捷有效的方法。

The effect of bionic tissue-engineered cartilage in repairing articular cartilage injury and the test value of ultrasonic elastography method

Objective In vitro construction of bionic tissue engineering cartilage and repair goat knee cartilage injury.Use of histological staining,mechanical analysis,ultrasound elastography examination,evaluation of the repair effect of this method,and the feasibility of noninvasive ultrasound evaluation.Methods 12 male goats were randomly divided into A,B,C three groups.Group A:two in blank control group.The knee weight-bearing area was 6 mm in diameter,with a full-thickness cartilage defect.Group B:four goats,Only bionic cartilage scaffold was implanted in the defect of the Weight-bearing area of the femoral condyle.Group C:six goats used the Bionic cartilage scaffolds were combined with autologous bone marrow mesenchymal stem cells was implanted in the defect of the Weight-bearing area of the femoral condyle.BMSCs were isolated from bone marrow blood and cultured.When the concentration of cells reached 1×10^7 cells/ml,they were load in to the bionic cartilage scaffold.The constructed bionic tissue engineering cartilage was implanted into the femoral condyle cartilage defect.In each group,the goat was made in the left knee first,then in the right knee three months after the operation,and then in the right knee three months after the operation,the ultrasonic examination was first,and then the gross score,pathological staining,GAG content determination and mechanical detection.Results In group A,there was no cartilage repair at there and six months.The results of gross score,pathological score,GAG content and mechanical detection showed that group C was better than group B(P<0.05),Moreover,in group B and group C,the 6 month group was better than the 3 month group(P<0.05).In group C,the 6 month group was closer to the normal cartilage tissue.The results of repair gross morphology and indentation test were consistent with those of ultrasonic elastography.Conclusions Using tissue engineering to construct bionic cartilage to treat early cartilage injury has a reliable therapeutic effect,and with the participation of autologous bone marrow mesenchymal stem cells can achieve better repair effect.The recovery period of cartilage injury after bionic cartilage repair is more than 6 months.Ultrasound elastography can be used as a simple,rapid and effective method to evaluate the recovery effect of cartilage transplantation.