中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (9): 1696-1700.doi: 10.3969/j.issn.1673-8225.2012.09.040

• 骨与关节综述 bone and joint review • 上一篇    下一篇

骨科局部应用抗生素对局部细胞的作用☆

曹  峥，侯树勋   

  1. 解放军总医院第一附属医院骨科研究所，北京市  100037
  • 收稿日期:2011-09-16 修回日期:2011-10-26 出版日期:2012-02-26 发布日期:2012-02-26
  • 通讯作者: 侯树勋，硕士，主任医师，博士生导师，解放军总医院第一附属医院骨科研究所，北京市100037 hsxortho@hotmail.com
  • 作者简介:曹峥☆，男，1984年生，江苏省徐州市人，汉族，解放军军医进修学院在读博士，医师，主要从事骨、软骨组织工程研究。 caozheng_81@163.com

Effects of local delivery antibiotics on cells in site

Cao Zheng, Hou Shu-xun   

  1. Department of Orthopedics, First Affiliated Hospital of Liberation Army General Hospital, Beijing  100037, China
  • Received:2011-09-16 Revised:2011-10-26 Online:2012-02-26 Published:2012-02-26
  • Contact: Hou Shu-xun, Master, Chief physician, Doctoral supervisor, Department of Orthopedics, First Affiliated Hospital of Liberation Army General Hospital, Beijing 100037, China hsxortho@hotmail.com
  • About author:Cao Zheng☆, Studying for doctorate, Physician, Department of Orthopedics, First Affiliated Hospital of Liberation Army General Hospital, Beijing 100037, China caozheng_81@163.com

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摘要：

背景：治疗骨与软组织感染，抗生素局部应用有低血药浓度、高局部药物浓度的优点，但是局部高浓度抗生素可能通过对局部细胞不同程度的作用影响愈合过程。
目的：了解抗生素对局部细胞的不同作用及作用原因和减轻不利影响的方法。
方法：检索Pubmed和中国生物医学文献数据库(CBM)中1990/2011收录的抗生素对骨科局部细胞作用的相关文献，选择针对性强、代表性好的40篇文献进行综述，分析抗生素对局部细胞的作用。
结果与结论：高浓度抗生素对细胞存活、增殖、代谢和分化主要表现为抑制作用，少数抗生素在特定剂量下表现为促进作用。不同抗生素作用不一。不同来源的细胞敏感性也不同。在去除抗生素后一段时间，细胞可表现出不同程度的恢复。调整局部pH值或者加入骨形态发生蛋白等方法可减轻细胞的抑制。对于骨科局部应用抗生素对局部细胞影响的研究使可以选择合适的抗生素及剂量治疗骨科局部感染，减少对局部愈合的影响，但仍需进一步深入研究。
关键词：抗生素；局部缓释；细胞；骨科；综述文献
doi:10.3969/j.issn.1673-8225.2012.09.040

关键词: 抗生素, 局部缓释, 细胞, 骨科, 综述文献

Abstract:

BACKGROUND: Local antibiotic delivery can achieve adequate local antibiotic levels and low serum concentrations for the treatment of bone and soft tissue infections. However, the toxic effects of high local antibiotic concentrations on local cells may affect the progress of healing.
OBJECTIVE: To understand the effects of antibiotics on local cells, and find a method to reduce the adverse effects of local antibiotics.
METHODS: PubMed database and Chinese Biomedical Literature Database (CBM) were searched for articles with the effects of antibiotics on orthopedics local cells published between 1990 and 2011. Totally 40 representative articles were selected to analyze the effects of antibiotics on local cells.
RESULTS AND CONCLUSION: At high antibiotic concentrations, most of antibiotics inhibited the survival, proliferation, metabolism and differentiation of cells. While in some conditions, few antibiotics enhance the proliferation, function and differentiation of some cells at special dosage. The effect depended on the kinds of antibiotics and cells. And the drug-induced cells alterations were reversible. The side effects of antibiotics could be overcome by bone morphogenetic protein and preventing the pH from decreasing in traumatized areas. The effects of local delivery antibiotics on cells in site can help to reduce side effect in the treatment of infection by the selection of appropriate kind and dosage of antibiotics. Further studies are needed to optimize local antibiotic delivery.

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