新型骨支架材料复合物修复兔下颌骨缺损的实验研究

目的研究纳米羟基磷灰石／胶原／聚乳酸／富血小板血浆复合物（nHAC／PLA／PRP）在骨缺损修复过程中的成骨作用。方法制备兔下颌骨10mm×8mm贯穿性缺损．按不添加材料A组、单纯材料（nHAC／PLA）B组、活性材料（nHAC／PLA／PRP）C组加入相应材料．术后2、4、8、12周处死动物，分别从大体、影像学、扫描电镜、组织学方面进行观察．计量新骨面积并进行方差分析。结果影像学观察B、C组2、4、8、12周缺损区密度均高于A组。B、C组之间差异无统计学意义。电镜观察3个组边界区主要由纤维组织包绕．B组边界区可见少量新生骨散在分布．C组纤维组织更致密，可见少量新骨片状分布；组织学观察可见B、C组各时间点骨缺损区新骨形成均优于A组．C组新生骨及新生血管的量较B组多。随着时间延长，各组新骨均有增多．残留的材料减少．有大量骨样组织长人活性材料，骨成熟度增高，残留材料逐渐被活跃生长的骨组织包围并替代。以方差分析对组间新骨面积进行两两比较，结果显示第2、4周两两组间差异有统计学意义．8、12周时A组与B、C组间差异有统计学意义．后两组之间差异无统计学意义。结论由nHAC／PLA和富血小板血浆（PRP）构建的复合材料具有良好的生物相容性、骨传导及骨诱导活性．有望应用于临床修复骨缺损。

Study on repair of mandibular defects with nano-hydroxyapatite/collagen/poly(lactic acid)/platelet-rich plasma compound in rabbits

Objective To investigate the osteogenesis effect of nHAC/PLA /PRP in bone defects repair. Methods A 10 mm × 8 mm perfoliate defect in right mandible of rabbit was made in each animal. Two different kinds of bone grafts were implanted respectively. Group A: no grafts; Group B: nHAC/PLA; Group C: nHAC/PLA/PRP compound. Two rabbits in each group were sacrificed at the 2nd、4th、8th、12th weeks, postoperative. The defects were evaluated by gross observation, radiography, scanning electron microscopy(SEM), histology and image analysis. The new bone areas were calculated using ANOVA(Analysis of Variance). Results At the 2nd、4th、8th、12th weeks, X-ray showed that the regenerative bone density of Group B and C was higher than Group A, but it was obvious between Group B and C; SEM scanning indicated that the boundary was mostly circled by fibrin, but a little new bone dispersedly distributes in Group B and there was more penetrating into materials in Group C later; histoligical observation showed that the amount and maturity of new bone in Group B and C were much higher than those in Group A at each time, the volumes of bone trabecula and new blood vessel were larger in Group C than those in Group B. The amount of trabecula increased and became more mature with time but the amount of residual materials reduced, an increasing amount of osteoid tissue developed into the inner materials. The new bone area was calculated using ANOVA and further Multiple Comparison, final result indicated that there was significance difference between each 2 groups at postoperative 2, 4 weeks, it also had statistical significance while compared Group A with Group B and C at the 8th, 12th weeks, but no statistical difference between the latter 2. Conclusion The nHAC/PLA/PRP exhibited good biocompatibility and osteoinduction so that it might be extensively used in clinical practise.