重组人粒细胞集落刺激因子干预后自体骨髓移植对骨折愈合的影响

背景：自体骨髓经皮移植促进骨折愈合已经成为临床一种治疗手段，其中骨髓间充质干细胞在局部微环境下所起到的作用已经得到共识。但是如何提高其在移植骨髓中的含量仍是目前面临的难题。已经有研究报道重组人粒细胞集落刺激因子(recombinant human granulocyte colony-stimulating factor，rhG-CSF)可动员外周骨髓间充质干细胞快速增殖。 目的：探讨rhG-CSF干预的自体骨髓移植对兔桡骨骨折愈合的促进作用。 方法：制备桡骨中段3 mm宽骨折模型白兔56只，随机分为4组，每组14只。术后1 h，rhG-CSF组，自体骨髓组与PBS对照组均在白兔背部皮下注射rhG-CSF，1次/d，连续5 d。模型组皮下注射相应体积的生理盐水。术后5 d，自体骨髓组抽取自体骨髓经皮回植骨折部位，PBS对照组在骨折处注射相应体积的生理盐水。术后14，28 d取材进行影像学、组织学、组织形态计量学检测与分析。 结果与结论：rhG-CSF，自体骨髓，PBS对照组新生血管、骨小梁形成、4种骨痂记分、外骨痂厚度均优于模型组，尤以自体骨髓组效果最显著(P < 0.01或P < 0.05)。说明rhG-CSF干预能够促进骨折愈合，结合自体骨髓移植促进骨折愈合的效果更佳。

Effect of autologous bone marrow transplantation on fracture healing following recombinant human granulocyte colony-stimulating factor intervention

BACKGROUND: It becomes a clinical method using autologous bone marrow transplantation to promote bone union, in which the role of bone mesenchymal stem cells in the local environment had been given consensus. However, how to increase content of mesenchymal stem cells in bone marrow transplantation is still in research. It have been reported that recombinant human granulocyte colony-stimulating factor (rhG-CSF) can mobilize peripheral mesenchymal stem cells proliferate rapidly. OBJECTIVE: To investigate the effects of autologous bone marrow transplantation mobilized by rhG-CSF on promoting fracture healing of rabbits with radius fracture. METHODS: Fifty-six rabbits replicated to fracture models and were randomly divided into 4 groups, with 14 animals in each group. One hour after operation, subcutaneous injection of rhG-CSF were given to rats in the rhG-CSF, autologous bone marrow and control groups, once per day, for 5 successive days. The appropriate volume of saline solution was injected into rats in the model group. At 5 days after operation, autologous bone marrow were extracted and transplanted into autologous fracture site in the autologous bone marrow group, the appropriate volume of saline solution was injected in the control group. The specimens were taken from the rabbits at postoperative 14 and 28 days and detected by imageology, histology and morphometry. RESULTS AND CONCLUSION: The new vessels, bone trabecula formation, scores of 4 callus and thickness of the external callus in the rhG-CSF, autologous bone marrow and control groups were superior to that of the model group, in particular in the autologous bone marrow group (P < 0.01 or P < 0.05). RhG-CSF intervention can promote fracture healing, and the effect would be better if combined with autologous bone marrow transplantation.