中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (3): 419-423.doi: 10.3969/j.issn.1673-8225.2010.03.010

• 药物控释材料 drug delivery materials • 上一篇    下一篇

藻酸钙万古霉素凝胶预防骨感染：不同给药途径影响药效吗？

于海泉1，冯文岭2，田玉良1   

  1. 1石家庄市中心医院骨三科，河北省石家庄市  050011；2河北医科大学第三医院骨伤科，河北省石家庄市  050051
  • 出版日期:2010-01-15 发布日期:2010-01-15
  • 通讯作者: 冯文岭，教授，硕士生导师，河北医科大学附属第三医院骨伤科，河北省石家庄市 050051 quandongwei@hotmail.com
  • 作者简介:于海泉★，男，1976年生，河北省清河县人，2008年河北医科大学毕业，硕士，主治医师，主要从事创伤骨科研究。 yufei318_2002@163.com

Prevention of bone infection using calcium alginate gel compound vancomycin: Do administration routes influence pharmacological action?

Yu Hai-quan1, Feng Wen-ling2, Tian Yu-liang1   

  1. 1 Third Department of Orthopaedics, Shijiazhuang Central Hospital, Shijiazhuang  050011, Hebei Province, China; 2 Department of Orthopaedics and Traumatology, Third Hospital of Hebei Medical University, Shijiazhuang  050051, Hebei Province, China
  • Online:2010-01-15 Published:2010-01-15
  • Contact: Feng Wen-ling, Professor, Master’s supervisor, Department of Orthopaedics and Traumatology, Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China quandongwei@hotmail.com
  • About author:Yu Hai-quan★, Master, Attending physician, Third Department of Orthopaedics, Shijiazhuang Central Hospital, Shijiazhuang 050011, Hebei Province, China yufei318_2002@163.com

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摘要：

背景：目前对骨感染的预防及治疗往往为全身用药，局部清创后静点抗生素预防及治疗骨感染，但局部血药浓度有限，全身不良反应较大，因此局部用药成为目前研究热点，其研究重点是寻找一种生物相容性较好，又可缓慢释放抗生素的载体。
目的：探讨藻酸钙凝胶复合万古霉素预防骨感染的能力，同时以万古霉素肌肉注射及磷酸三钙复合万古霉素植入造模区进行对照。
方法：以60只健康成年新西兰白兔为实验对象，各组右侧胫骨采用胫骨髓腔注射金黄色葡萄球菌的方法诱导骨髓炎生成，造模后全身用药组给予肌注万古霉素(0.03 g，2次/d，共4 d)，磷酸三钙组放置1 g磷酸三钙与0.1 g万古霉素复合体填充于造模区，骨蜡封闭，缝合，藻酸钙凝胶组局部造模后放置万古霉素藻酸钙凝胶。分别于术后4，8周进行大体观察，放射影像，组织学分析。
结果与结论：术后全身用药组以及磷酸三钙组大部分出现局部肿胀，并出现局部窦道、渗出。全身用药组及磷酸三钙组病理切片见大量淋巴细胞以及部分死骨，并可见部分脓腔。藻酸钙凝胶组其组织学和大体观察均无骨髓炎表现。提示复合万古霉素藻酸钙凝胶预防骨感染效果优于局部给予磷酸三钙复合万古霉素以及全身应用万古霉素。

关键词: 藻酸钙凝胶, 万古霉素, 预防, 骨感染, 缓慢释放, 生物材料

Abstract:

BACKGROUND: Systemic administrations are widely used in preventing or curing bone infections, however, it accompanied by great adverse reactions and limited local blood drug levels. Therefore, local administration becomes a research focus, which aimed to explore a carrier possess good biocompatibility and slow-release antibiotics. 
OBJECTIVE: To explore the effect of calcium alginate gel compound vancomycin on prevention of bone infection, simultaneously, single drug was injected or implanted into models to compare the results.
METHODS: A total of 60 healthy adult New Zealand white rabbits were prepared for osteomyelitis models by injecting Staphylococcus aureus to right tibiae medullaris, and randomly divided into systemic treatment, tricalcium phosphate and calcium alginate gel groups. After model preparation, rabbits in the systemic treatment group were intramuscular injected vancomycin (0.03 g, twice per day, for 4 successive days); in the tricalcium phosphate group, 1 g tricalcium phosphate combined with 0.1 g vancomycin was filled in the defects, sealed with bone wax. In the calcium alginate gel group, calcium alginate gel combined with vancomycin was implanted. Gross observation, radiological image and histological analysis were performed at weeks 4 and 8 after operation.
RESULTS AND CONCLUSION: Local swelling and partial sinus were found in the systemic treatment and tricalcium phosphate groups after operation. The pathological slice showed that there were a large number of lymphocytes and some sequestrum in the systemic treatment and tricalcium phosphate groups. However, there was no manifestation of osteomyelitis in the calcium alginate gel group. The results suggested that calcium alginate gel compound vancomycin exhibit superior therapeutic effect on prevention of bone infection to local administration of calcium alginate gel combined with vancomycin or systemic application of vancomycin.

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