中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (8): 1075-1080.doi: 10.3969/j.issn.2095-4344.2016.08.002

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

自体骨髓富集间质干细胞与羟基磷灰石磷酸三钙材料复合在脊柱融合中的应用

闫 伟1，杨 莉1，凌 梅2，甘嘉亮3   

  1. 1河南省安阳地区医院，河南省安阳市 455001；2新乡医学院第一附属医院，河南省新乡市 453000；3广州医学院荔湾医院，广东省广州市 510170
  • 收稿日期:2016-01-03 出版日期:2016-02-19 发布日期:2016-02-19
  • 通讯作者: 甘嘉亮，硕士，广州医学院荔湾医院，广东省广州市 510170
  • 作者简介:闫伟，男，1977年生，河南省安阳市人，副主任医师，主要从事脊柱、创伤方面的研究。
  • 基金资助:
    广州市医药卫生科技项目(201102A212002)；广州市荔湾区科技计划项目(20124313106-2)；广州市医药卫生科技项目(20142A010022)

Autologous bone marrow mesenchymal stem cells combined with hydroxyapatite/ tricalcium phosphate complex in the spinal fusion

Yan Wei1, Yang Li1, Ling Mei2, Gan Jia-liang3   

  1. 1Anyang District Hospital, Anyang 455001, Henan Province, China; 2First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453000, Henan Province, China; 3Liwan Hospital of Guangzhou Medical College, Guangzhou 510170, Guangdong Province, China
  • Received:2016-01-03 Online:2016-02-19 Published:2016-02-19
  • Contact: Gan Jia-liang, Master, Liwan Hospital of Guangzhou Medical College, Guangzhou 510170, Guangdong Province, China
  • About author:Yan Wei, Associate chief physician, Anyang District Hospital, Anyang 455001, Henan Province, China
  • Supported by:

    the Medicine and Health Scientific Projects of Guangzhou City, No. 201102A212002, 20142A010022; the Scientific Research Plan of Liwan District of Guangzhou, No. 20124313106-2

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575

被引次数

3

摘要：

文章快速阅读：

文题释义：

骨髓干细胞富集技术：骨髓中的间质干细胞数量较少，应用密度梯度离心方法能快速富集骨髓间质干细胞，可使单位体积内的骨髓间质干细胞浓度提高8-10倍，增加骨髓间质干细胞分化为成骨细胞克隆的数量。
脊椎融合：将植骨放在脊柱两运动节段间进行融合，而植骨放入方向有从前方置入的前方椎间融合，从后方置入有3种可选择方式，即后方椎间融合、后方骨融合、后侧方骨融合。这几种方式最大的不同即是植骨的位置不同。椎间融合是将植骨放在两椎体之间，后方骨融合是将植骨放在椎板上或固定两棘突之间，后侧方骨融合是植骨放在两横突之间。这3种植骨位置截然不同，进而也使得力学的传递有显著差异。

 

背景：脊柱融合过程中使用一定的骨移植材料可以达到促进骨融合、增强脊柱稳定性的效果。

目的：探讨自体骨髓富集的间质干细胞复合羟基磷灰石磷酸三钙在脊柱融合中的应用效果。
方法：回顾性分析64例行脊柱融合患者的临床资料，按照植骨融合材料的不同分为对照组(32例)和观察组(32例)，分别予以自体髂骨移植和自体骨髓富集的间质干细胞复合羟基磷灰石磷酸三钙移植。治疗后随访12个月，对两组患者腰背疼痛、脊柱融合、伤椎复位情况等进行评估。

结果与结论：治疗后两组患者LBOS评分、LBOS评分优良率、脊柱融合Lenke分级、Cobb角经比较差异无显著性意义(P > 0.05)。两组患者均未出现感染和炎症表现，内固定物对皮肤无刺激现象。两组患者凝血功能、肾功能、炎性因子相关指标均处于正常水平，差异无显著性意义(P > 0.05)。试验结果表明，自体骨髓富集的间质干细胞复合羟基磷灰石磷酸三钙应用于脊柱融合可以获得与自体髂骨移植基本相当的临床效果。 

ORCID: 0000-0002-1999-1962(闫伟)

关键词: 生物材料, 骨生物材料, 羟基磷灰石, 磷酸三钙, 自体富集干细胞技术, 骨髓间充质干细胞, 生物相容性

Abstract:

BACKGROUND: The use of bone graft materials can promote bone fusion and enhance the stability of the spine during the spinal fusion.
OBJECTIVE: To investigate the effect of autologous bone marrow mesenchymal stem cells with hydroxyapatite/ tricalcium phosphate in the spinal fusion.
METHODS: A retrospective analysis of clinical data of 64 patients with spinal fusion was carried out, and these patients were divided into two groups (n=32 per group): control group undergoing autogenous iliac bone grafting and observation group undergoing autologous bone marrow mesenchymal stem cells combined with hydroxyapatite/tricalcium phosphate. All patients were followed up for 12 months, and their recovery conditions about low back pain, spinal fusion and vertebral reset were assessed.
RESULTS AND CONCLUSION: The low-back outcome scale scores and excellent rate, Lenke grading and Cobb angle had insignificant differences between the two groups after treatment (P > 0.05). No infection, inflammation and skin irritation occurred in the two groups. The coagulation function, renal function and inflammatory factor levels were at normal levels in all the patients, and there was no difference between the two groups (P > 0.05). These findings indicate that autologous bone marrow mesenchymal stem cells combined with hydroxyapatite/tricalcium phosphate can achieve clinical outcomes equivalent to the autologous iliac bone grafting.