中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (12): 1906-1913.doi: 10.12307/2023.036

• 纳米生物材料 nanobiomaterials • 上一篇    下一篇

富血小板血浆及浓缩生长因子和微纳米3D复合支架修复兔桡骨缺损的比较

冯俊铭1,熊贤梅1,马立琼1,张  严1,陈梓杰1,李世杰1,陈柏行1,姜自伟1,2,曾展鹏1,2,高怡加1,2   

  1. 1广州中医药大学,广东省广州市  510405;2广州中医药大学第一附属医院一骨科,广东省广州市  510405
  • 收稿日期:2021-12-10 接受日期:2022-01-27 出版日期:2023-04-28 发布日期:2022-07-30
  • 通讯作者: 高怡加,硕士,主任医师,广州中医药大学第一附属医院一骨科,广东省广州市 525000
  • 作者简介:冯俊铭,男,1995年生,广东省高州市人,汉族,广州中医药大学在读硕士,主要从事中医药防治骨与关节损伤方面的研究。
  • 基金资助:
    广东省自然科学基金项目(2018A030313369),项目负责人:高怡加

Comparison of platelet-rich plasma, concentrated growth factor and 3D micro-nanostructure composite scaffolds in repair of rabbit radius defects

Feng Junming1, Xiong Xianmei1, Ma Liqiong1, Zhang Yan1, Chen Zijie1, Li Shijie1, Chen Baixing1, Jiang Ziwei1, 2, Zeng Zhanpeng1, 2, Gao Yijia1, 2    

  1. 1Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; 2First Department of Orthopedics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Received:2021-12-10 Accepted:2022-01-27 Online:2023-04-28 Published:2022-07-30
  • Contact: Gao Yijia, Master, Chief physician, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China; First Department of Orthopedics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • About author:Feng Junming, Master candidate, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:
    the Natural Science Foundation of Guangdong Province, No. 2018A030313369 (to GYJ)

摘要:

文题释义:
骨缺损:指骨结构完整性缺失,一般由先天畸形、感染、严重的开放性骨折、骨肿瘤、骨坏死病灶清除术后等因素造成。当骨缺损累及长度达到骨干直径的两三倍时,将超过自体修复的临界状态,常常会出现骨不连等并发症,治疗周期延长且预后不良,如何处理骨缺损是非常棘手的问题。
微纳米3D复合支架:纳米级羟基磷灰石粉粒较普通羟基磷灰石的物理性能更加稳定,且表面积大,与蛋白质有很强的结合能力,以纳米级羟基磷灰石为原料混合其他成分通过3D打印的复合支架具有微孔结构,可促进骨细胞附着、增殖和迁移,从而促进骨的愈合。

背景:近年来,富血小板血浆、浓缩生长因子和3D打印的纳米级羟基磷灰石支架成为骨移植的热门研究材料,目前这些材料的研究方向较分散,现有研究中鲜有针对大段骨缺损的治疗且缺乏不同类型材料的比较,因长骨干的主要成分为皮质骨,其愈合更具挑战。
目的:通过实验评估和比较富血小板血浆、浓缩生长因子和微纳米3D复合支架对骨缺损愈合的影响。
方法:纳入32只新西兰大白兔,制备桡骨15 mm骨缺损模型,根据不同移植物随机分为4组:空白组(不做处理)、富血小板血浆组(富血小板血浆)、浓缩生长因子组(浓缩生长因子)和3D复合支架组(微纳米3D复合支架),每组8只。术后第1天及第6,12周行X射线检查,在术后12周先行行为学观察,之后取兔尺桡骨标本行Micro CT扫描,对比骨密度和骨体积分数,最后将骨标本切片后显微镜下观察。
结果与结论:①富血小板血浆组、浓缩生长因子组和3D复合支架组均有不同程度的新骨形成,行为学观察差异较小;而空白组基本无新骨形成,术后12周均出现明显的跛行;②在术后6,12周的X射线成像上各干预组要优于空白组,而各干预组之间对比灰度值差异也较明显,但富血小板血浆组和浓缩生长因子组在12周未见明显差异;③术后12周富血小板血浆组和浓缩生长因子组在骨密度和骨量对比上无显著差异,但各参数均优于3D复合支架组;④提示富血小板血浆和浓缩生长因子无疑能促进早期新骨形成,且两者在长远影响中无明显差异;由羟基磷灰石制作的无机材料支架难以完全促进骨缺损愈合,需加入其他有机成分改善其性能才能发挥最大的成骨效能。

https://orcid.org/0000-0001-8564-3133 (冯俊铭) 

中国组织工程研究杂志出版内容重点:生物材料;骨生物材料口腔生物材料纳米材料缓释材料材料相容性组织工程

关键词: 骨缺损, 富血小板血浆, 浓缩生长因子, 羟基磷灰石, 复合支架, 桡骨, 骨愈合

Abstract: BACKGROUND: In recent years, platelet-rich plasma, concentrated growth factors, and 3D-printed nanoscale hydroxyapatite scaffolds have become popular research materials for bone transplantation. At present, the research directions of these materials are scattered, and there are few existing studies targeting large segments of bone and lack of comparison of different types of materials. Because the main component of long diaphysis is cortical bone, its healing is challenging.
OBJECTIVE: To evaluate and compare the effects of platelet-rich plasma, concentrated growth factor, and 3D micro-nanostructure composite scaffold on bone defect healing. 
METHODS: Thirty-two New Zealand white rabbits were enrolled to prepare radial bone defect model of 15 mm. According to the graft, they were divided into four groups (n=8): blank group (no treatment), platelet-rich plasma group (platelet-rich plasma), concentrated growth factor group (concentrated growth factor) and 3D composite scaffold group (3D micro-nanostructure composite scaffold). X-ray examination was performed at 1 day, 6 and 12 weeks postoperatively. Behavioral observation was performed at 12 weeks postoperatively. The rabbit ulnar and radial bone specimens were taken for Micro CT scanning to compare bone mineral density and bone volume fraction. Finally, the bone specimens were sliced and observed under a microscope. 
RESULTS AND CONCLUSION: (1) The platelet-rich plasma, concentrated growth factor, and 3D composite scaffold groups had different volumes of new bone with little behavioral difference, while the blank group had almost no new bone formation and obvious claudication occurred at 12 weeks after operation. (2) X-ray imaging was better in each intervention group than that in the blank group at 6 and 12 weeks after surgery. The difference in gray values was obvious between the intervention groups, but there was no significant difference between platelet-rich plasma and concentrated growth factor groups at 12 weeks. (3) At 12 weeks after surgery, there was no statistically significant difference in bone mineral density and bone mass between the platelet-rich plasma and concentrated growth factor groups, but all parameters were better than those in the 3D composite scaffold group. (4) It is concluded that undoubtedly platelet-rich plasma and concentrated growth factor can promote the early formation of new bone, but there is no significant difference in the long-term effects of platelet-rich plasma and concentrated growth factor. The inorganic scaffold made of hydroxyapatite is difficult to promote the healing of bone defects completely, and other organic components must be added to improve its performance to maximize the osteogenic effect.

Key words: bone defect, platelet-rich plasma, concentration growth factor, hydroxyapatite, composite scaffold, radius, bone healing

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