中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (43): 6396-6402.doi: 10.3969/j.issn.2095-4344.2016.43.002

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

硫酸钙人工骨复合培养骨髓间充质干细胞对骨诱导脊柱融合的影响

应吕方1，贾叙锋2，程  尹1，冯大雄1
  

  1. 1西南医科大学附属医院脊柱外科，四川省泸州市  646000；2四川简阳市人民医院骨科，四川省简阳市  641400
  • 收稿日期:2016-08-20 出版日期:2016-10-21 发布日期:2016-10-21
  • 通讯作者: 冯大雄，博士，教授，主任医师，西南医科大学附属医院脊柱外科，四川省泸州市 646000
  • 作者简介:应吕方，男，1990年生，浙江省宁波市人，汉族，2014年川北医学院毕业，西南医科大学在读硕士。
  • 基金资助:

    国家自然科学基金(30872602)

A tissue-engineered bone constructed with bone marrow mesenchymal stem cells and calcium sulfate artificial bone: its osteoinductive effects in spinal fusion

Ying Lv-fang1, Jia Xu-feng2, Cheng Yin1, Feng Da-xiong1
  

  1. 1Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China; 2Department of Orthopedics, People’s Hospital of Jianyang in Sichuan, Jianyang 641400, Sichuan Province, China
  • Received:2016-08-20 Online:2016-10-21 Published:2016-10-21
  • Contact: Feng Da-xiong, M.D., Professor, Chief physician, Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • About author:Ying Lv-fang, Studying for master’s degree, Department of Spine Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 30872602

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被引次数

3

摘要：

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文题释义：
脊柱融合：融合过程中以患者的病损脊椎为中心，从病损区上位的正常脊椎到下位的正常脊椎作植骨术，使多个节段发生骨性连接，融合成一片，形成一个力学上的整体，从而重建脊柱稳定性。
硫酸钙人工骨材料：是目前国内外研究和应用较多的骨替代材料之一，其理化性质与骨组织相似，生物相容性良好，具有一定的传导成骨能力，并能在体内进行生物降解。 

背景：硫酸钙人工骨可降解，且具有良好的生物相容性，是作为一种骨移植替代物应用于脊柱融合治疗中。
目的：观察硫酸钙人工骨复合培养骨髓间充质干细胞对骨诱导脊柱融合的影响。
方法：体外培养人骨髓间充质干细胞，并与硫酸钙人工骨进行复合，电镜下观察复合材料情况。纳入行脊柱融合患者67例，按照植骨融合材料的不同分为对照组32例和观察组35例，分别予以自体髂骨移植和自体骨髓间质干细胞复合硫酸钙移植，术后进行脊柱融合Lenke分级和腰背疼痛疗效结果评分。
结果与结论：①电镜下观察材料细胞形态：硫酸钙人工骨具有良好的孔状结构，骨髓间充质干细胞在硫酸钙人工骨材料上生长良好，细胞贴敷于材料上；②脊柱融合情况：术后对患者的脊柱融合Lenke分级情况进行比较，观察组的Lenke分级情况稍优于对照组，但差异无显著性意义(P > 0.05)，与术前相比，两组腰背疼痛疗效结果评分均显著增高(P < 0.05)；③结果表明：利用硫酸钙人工骨为支架材料，骨髓间充质干细胞为种子细胞，构建组织工程骨，并应用于脊柱融合之中可以发挥出良好的骨诱导作用，获得理想的治疗效果。

关键词: 生物材料, 骨生物材料, 脊柱融合, 骨移植, 硫酸钙, 人工骨, 种子细胞, 骨髓间充质干细胞, 骨诱导, 支架材料, 国家自然科学基金

Abstract:

BACKGROUND: Biodegrable calcium sulfate artificial bone has a good biocompatibility, so it is used as a bone graft substitute in the treatment of spinal fusion.
OBJECTIVE: To investigate the osteoinductive effects of the tissue-engineered bone made of bone marrow mesenchymal stem cells and calcium sulfate artificial bone in spinal fusion.
METHODS: Bone marrow mesenchymal stem cells were cultured in vitro, and then combined with the calcium sulfate artificial bone. The composite material was observed under electron microscope. Totally 67 patients undergoing spinal fusion were enrolled, who were divided into control group (n=35) and observation group (n=32), receiving autologous iliac bone graft and autologous bone marrow mesenchymal stem cells combined with calcium sulfate transplantation, respectively. Subsequently, spinal fusion Lenke classification and low back outcome score were conducted.
RESULTS AND CONCLUSION: Under electron microscope, the visible calcium sulfate artificial bone presented a good porous structure, on which bone marrow mesenchymal stem cells grew and adhered well. Slightly but insignificantly better outcomes in the spinal fusion through the use of the Lenke classification system were obtained in the observation group than the control group after surgery (P > 0.05). Besides, scores on low back outcomes in both two groups were significantly higher than baseline data (P < 0.05). These results suggest that the tissue-engineered bone made of calcium sulfate artificial bone as the scaffold and bone marrow mesenchymal stem cells as seed cells can exert a good osteoinduction in spinal fusion, and obtain ideal effects.

Key words: Stem Cells, Tissue Engineering, Spine

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