中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (42): 6290-6295.doi: 10.3969/j.issn.2095-4344.2016.42.009

• 软骨组织构建 cartilage tissue construction • 上一篇    下一篇

羟基磷灰石-骨形态发生蛋白复合人工听小骨与同种异体软骨听骨赝复物修复听骨链损伤的比较

张学红,梁小微,陆鸿略,禹淑杰,王鸿梅,张宇丽   

  1. 承德医学院附属医院耳鼻喉科,河北省承德市  067000
  • 收稿日期:2016-07-24 出版日期:2016-10-14 发布日期:2016-10-14
  • 通讯作者: 梁小微,承德医学院附属医院耳鼻喉科,河北省承德市 067000
  • 作者简介:张学红,1968年生,女,汉族,河北省承德市人,硕士,主要从事耳鼻喉科临床研究。
  • 基金资助:

    承德科技局项目(201422024):影响突发性耳聋预后相关因素的回顾性研究

Hydroxyapatite-bone morphogenetic protein ossicular prosthesis versus allogeneic cartilage ossicular prosthesis for ossicular chain damage

Zhang Xue-hong, Liang Xiao-wei, Lu Hong-lue, Yu Shu-jie, Wang Hong-mei, Zhang Yu-li   

  1. Department of Otorhinolaryngology, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
  • Received:2016-07-24 Online:2016-10-14 Published:2016-10-14
  • Contact: Liang Xiao-wei, Department of Otorhinolaryngology, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
  • About author:Zhang Xue-hong, Master, Department of Otorhinolaryngology, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
  • Supported by:

    the Scientific Project of Chengde Science and Technology Department, No. 201422024

摘要:

文章快速阅读:

文题释义:
理想的听骨损伤修复材料:置入的材料必须无毒性;材料具备稳定的化学特性,生物相容性良好,能够与周围骨质紧密结合,不会产生排斥反应;选择的材料尽可能与骨组织结构类似,容易加工、保存,具备长期稳定的声音传导性,不会出现不良反应。
新型羟基磷灰石-骨形态发生蛋白复合人工听小骨:羟基磷灰石是临床上使用较多的修复材料,该材料具备多孔性,置入体内后,其材料内部三维交通的空隙结构能够为骨形态发生蛋白的吸附提供充分的空间,更加有利于营养成分的渗透和血管化。骨形态发生蛋白载体及研究进一步拓展了应用空间,它是目前公认的能诱导异位成骨的细胞因子。目前,应该骨形态发生蛋白基因结合骨组织工程方法对软骨缺损进行修复。骨形态发生蛋白2属于骨形态发生蛋白亚型的一种,具有较强的水溶性,半衰期相对比较短,能够在机体内弥散,从而能够提高患者听力。
摘要
背景:
在听骨链损伤的治疗过程中,使用何种修复材料尚存在较大的争议。
目的:对比新型羟基磷灰石-骨形态发生蛋白复合人工听小骨与同种异体软骨听骨赝复物修复听骨链损伤的效果。
方法:将60例慢性中耳炎患者分为对照组和试验组,每组30例。两组患者均行鼓室成形、听骨链重建治疗,对照组采用同种异体软骨听骨赝复物修复,试验组采用新型羟基磷灰石-骨形态发生蛋白复合人工听小骨修复,治疗后随访12个月,对比两组修复效果。
结果与结论:①空气传导值与气骨间隙值:两组治疗后的空气传导值与气骨间隙值均较治疗前显著改善(P < 0.05),试验组治疗后的空气传导值较对照组改善更明显(P < 0.05);②植入物脱出率:试验组未发生植入物脱出,对照组3例发生植入物脱出;③听力提高情况:试验组28例听力得到提高,提高率为93%;对照组25例听力得到提高,提高率为83%,两组间听力提高率比较差异有显著性意义(P < 0.05);④结果表明:新型羟基磷灰石-骨形态发生蛋白复合人工听小骨修复听骨链损伤,可获得与同种异体骨听骨赝复合物类似的修复效果。

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程
ORCID: 0000-0002-1741-7721(梁小微)

关键词: 组织构建, 软骨组织工程, 新型羟基磷灰石-骨形态发生蛋白复合人工听小骨, 同种异体软骨, 听骨赝复物, 听骨链损伤, 修复效果

Abstract:

BACKGROUND: There is a great dispute on the choice of repair materials for ossicular chain damage.
OBJECTIVE: To explore the effects of new hydroxyapatite-bone morphogenetic protein ossicular prosthesis versus allogeneic cartilage ossicular prosthesis in patients with ossicular chain damage.
METHODS: Sixty patients with chronic otitis media were equally assigned into a control group and a test group. Two groups of patients underwent tympanoplasty and ossicular chain reconstruction with allogeneic cartilage ossicular prosthesis or hydroxyapatite-bone morphogenetic protein ossicular prosthesis, respectively. Twelve months after surgery, follow-up results were compared between two groups.
RESULTS AND CONCLUSION: Air conduction value and air-bone gap value were both improved significantly in the two groups after surgery (P < 0.05), and especially, the postoperative air conduction value was better in the test group than the control group (P < 0.05). Implant detachment was found in three cases of the control group, whereas did not occur in the test group. Improved hearing was found in 28 cases in the test group with an improvement rate of 93% and 25 cases in the control group with an improvement rate of 83%. There was a significant difference in the hearing improvement between the two groups (P < 0.05). Overall, two kinds of prostheses can share similar effects on the ossicular chain repair.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Tympanoplasty, Otitis Media, Bone Morphogenetic Proteins, Tissue Engineering

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