摘要
目的观察自体富血小板血浆(platelet-rich plasma,PRP)诱导骨髓基质干细胞联合同种骨软骨支架治疗早期兔激素性股骨头坏死的疗效,探索早期股骨头坏死治疗的新方法。方法采用含有抗凝剂的真空采血管从实验兔的耳中央动脉采取动脉血5mL,再通过离心方法获取PRP,用16号骨髓穿刺针从实验兔自体股骨髓腔抽取骨髓5mL,把抽取的骨髓进行密度梯度离心,获取兔骨髓基质干细胞,并进行细胞原代培养和成骨诱导。对已获取PRP和骨髓基质干细胞的实验兔进行激素性股骨头坏死造模,取同种股骨髁部骨软骨制作软骨支架,最后以制备的软骨支架为载体,将经过成骨诱导的骨髓基质干细胞移植到软骨支架上,形成细胞-支架复合物,用16号骨髓穿刺针对坏死的股骨头进行髓芯减压术,术中将细胞-支架复合物植入坏死的股骨头下。实验动物共分为4组,每组20只,A组为空白对照;B组仅进行髓芯减压;C组髓芯减压后植入经过成骨诱导培养的细胞;D组髓芯减压后植入细胞-支架复合物。实验后在第2、4、8周各组分别处死6、6、8只,每只实验兔的股骨头行大体标本及组织学检查。结果 D组治疗效果最显著,通过空骨陷窝计数发现D组与其他各组的差异有统计学意义(P<0.05)。结论骨髓基质干细胞通过PRP的诱导向成骨细胞分化;软骨支架材料为骨髓基质干细胞向成骨细胞分化提供良好的空间结构,有利于其向成骨细胞分化;PRP和软骨支架材料联合应用可促进早期兔激素性股骨头坏死的修复。
Objective To observe the therapeutic effect of autologous platelet-rich plasma（PRP）induced bone marrow stromal stem cells（BMSCs）combined with the same osteochondral scaffolds in the treatment of early femoral head necrosis in rabbits and to explore a new method for the treatment of early steroid-induced femoral head necrosis.Methods 5mL of arterial blood was taken from the central artery of the experimental rabbits by using the anticoagulant-containing vacuum blood collection tube.Then the platelet-rich plasma（PRP）was obtained from those blood by centrifugation.5mL of bone marrow was extracted from the autologous femoral cavity of the rabbits by the 16 th bone marrow aspiration needle.The rabbit bone marrow stromal stem cells were obtained from those bone marrow by density gradient centrifugation for the primary culture and osteogenesis induction of cells.Then,the rabbits of the extracted PRP and BMSCs were made as the steroid-induced femoral head necrosis models.The same kind of femoral condyle bone cartilage was taken to produce the cartilage scaffold.Finally,BMSCs induced by osteogenesis were transplanted into cartilage scaffolds to form cell-scaffold complexes.The bone-core decompression was performed on the necrotic femoral head with the 16 th bone marrow aspiration needle,and the cell-scaffold complex was implanted into the necrotic femoral head.The rabbits were divided into four groups and each group consisted of 20 rabbits.Different groups were given different interventions：Group A was the blank control;Group B was only given decompression of core decompression;Group C was treated with the implantation with osteoblastinduced cells after decompression;Group D was administered with the implantation with cell-scaffold complex.6rabbits in each group were sacrificed at Week 2and 4respectively,and the other 8rabbits were sacrificed at Week8.The gross and histological examinations were performed in all the femoral heads.Results The therapeutic effect of Group D was the most significant,and Group D was significantly different from the other three groups respectively in the numbers of empty bone lacunae（P〈0.05）.Conclusion The bone marrow stromal cells differentiate into osteoblasts by the induction of platelet-rich plasma.Cartilage scaffolds provide a good spatial structure for differentiation of bone marrow stromal cells into osteoblasts in order to differentiate into osteoblasts.Platelet-rich plasma and cartilage scaffolds can be combined together to promote the repair of early steroid-induced femoral head necrosis of rabbits.
出处
《成都医学院学报》
CAS
2017年第3期265-270,276,共7页
Journal of Chengdu Medical College
基金
四川省卫生厅科研基金资助项目(No:120483)
关键词
富血小板血浆
骨髓基质干细胞
软骨支架
激素性股骨头坏死
Platelet-rich plasma
Bone marrow stromal stem cells
Cartilage scaffold
Steroid-induced femoral head necrosis
