重组人工骨移植修复节段性骨缺损的实验研究

目的 探讨重组人胰岛素样生长因子-1（recombinant human insulin—like growth factor1，rhIGF-1）／珊瑚羟基磷灰石（eoralline hydroxyapatite，CHA）／自体红骨髓（autogeneous red bonemarrow，ARBM）复合构建重组人工骨修复骨缺损的能力。方法 成年中国家兔54只，随机分为3组，每组18只。制成双侧桡骨干11mm骨-骨膜全层缺损模型，每组动物双侧缺损分别随机植入两种不同材料，形成自体对照的实验组和对照组。1组：实验组（A组，植入CHA／ARBM／rhIGF-1）和对照组（B组，植入CHA／ARBM）；2组：实验组（C组，植入CHA／rhIGF-1）和对照组（D组，植入CHA）；3组：实验组（E组，植入取自埘侧相应缺损骨段的自体骨）和对照组（F组，缺损旷置）。于术后2、4、8和12周行X线片观察、计算机图像分析、组织学观察和生物力学检测，比较各组修复骨缺损能力。结果 A组在各时间点X线片及计算机图像分析均优于其它各组，差异有统计学意义（P〈0．01）。组织学观察A组12周时可形成均匀致密的板层骨，整个过程与自体骨移植后组织形态学变化基本相似。12周抗弯生物力学测试，A组和E组间差异无统计学意义（P〉0．05），但显著优于其它各组（P〈0．01）；C组和D组各时间点差异无统计学意义（P〉0．05），成骨效果低于A、B和E组。12周时F组缺损未修复。结论 CHA／ARBM／rhIGF-1重组后可协同实现骨再生、骨传导和骨诱导三重促成骨功效，可替代自体骨移植，成为一种新型的复合活性人工骨。

AN EXPERIMENTAL STUDY ON RECOMBINANT ARTIFICIAL BONE SUBSTITUTE FOR REPAIRING SEGMENTAL BONE DEFECT IN RABBITS

Objective To investigate the ability of repairing bone defect with the compound of recombinant human insulin-like growth factor 1(rhIGF-1),coralline hydroxyapatite(CHA) and autogeneous red bone marrow(ARBM),and to study the feasibility of the compounds being used as bone substitute materials.Methods Bilateral radius bone defects(11 mm in length) were created in 54 Chinese rabbits,which were randomly divided into 3 groups,and two different materials were randomly transplanted into the bilateral defects:in group 1,with material A(rhIGF-1/CHA/ARBM) and material B(CHA/ARBM);in group 2,with material C(rhIGF-1/CHA) and material D(CHA);in group 3,with E(autograft) and F(no implant) as controls.At 2,4,8 and 12 weeks,the effects were assessed by X-ray and image analysis,biomechanics(at 12 weeks),as well as histological observation.Results X-ray and image analysis showed that material A of group 1 was significantly superior to any other materials(P<0.01).Anti-bending biomechanic detection showed that material A and E was significantly superior to the other materials(P<0.01),but no significant difference was found between A and E in the 12th week((P>0.05)).And by histological observation,in analogical bone morphological progress,materials C and D obviously inferior to materials A,B and E,but there was no significant difference between materials C and D.F had no evidence of new bone rebridging.Conclusion The recombinant compound CHA/ARBM(rhIGF-1),which posseses the potential ability of osteogenesis,osteoconduction and osteoinduction for bone defect repairing,can serve as a new type of autogenous bone substitute material.