血管束植入联合细胞移植治疗兔股骨头坏死模型的实验研究

摘要

目的:探讨血管束植入联合同种异体骨髓基质干细胞移植治疗兔股骨头坏死骨缺损模型的可行性,探索治疗股骨头坏死的一种新方法.方法:36只新西兰大耳白兔随机分成A、B、C3组,每组12只,所有动物的双侧股骨头均参加实验.用液氮冷冻法造模,股骨头钻孔造成骨缺损.A组为空白对照组,B组为同种异体骨髓基质干细胞移植组,C组为同种异体骨髓基质干细胞移植联合血管束植入组.分别于术后2、4、8、12用处死3只实验动物.所获的股骨头标本分别做组织切片HE染色,进一步测算股骨头冠状截面的血管密度及新生骨小梁在骨缺损区所占的面积百分比,做统计分析.结果:C组股骨头缺损区2周时可见新生骨小梁和原始毛细血管形成,8周时新生骨小梁板层状或编织状,毛细血管丰富,12周时骨小梁变宽变粗,排列规则,可见成熟的骨小梁及新生骨髓.B、C两组股骨头冠状截面的血管密度及新生骨小梁在骨缺损区所占的面积比,2周时差异无统计学意义,4、8、12周时C组股骨头冠状截面的血管密度及新生骨小梁在骨缺损区所占的面积比均比同时期B组大.结论:体外培养的同种异体骨髓基质干细胞能在股骨头坏死骨缺损区形成新生骨小梁,可以用作异体移植.植入股骨头坏死骨缺损区的血管束可以有效改善股骨头的血运,促进新生骨小梁的形成.%Objective:To discuss the feasibility of vascular bundle implantation combined with allogeneic bone marrow stromal cells (BMSCs) transplantation in treating rabbit femoral head osteonecrosis and bone defect, in order to explore a new method for the treatment of femoral head necrosis. Methods: Thirty-six New Zealand rabbits were randomly divided into three groups, with 12 rabbits in each group. Bilateral femoral heads of the rabbits were studied in the experiment. The models were made by liquid nitrogen frozen,and the femoral heads were drilled to cause bone defect. Group A was the control group,group B was stem cells transplantation group of allograft marrow stromal, and group C was stem cells transplantation group of allograft marrow stromal combined with vascular bundle implantation. Three rabbits of each group were sacrificed respectively at 2,4,8,12 weeks after operation. All specimens of the femoral heads were sliced for HE staining. Furthermore, vascular density and the percentage of new bone trabecula of femoral head coronary section in defect area were measured and analyzed statistically. Results: In group C, new bone trabecula and original micrangium formed at the 2nd week after operation; new bone trabecula was lamellar and interlaced with abundant micrangium at the 8th week;at the 12th week,the broadened,coarsened bone trabecula lined up regularly, and the mature bone trabecula and new marrow were visible. At the 2nd week after operation, there was no statistical significance in the percentage of new bone trabecula of femoral head coronary section in defect area between group B and C. While at 4,8,12 week after operation, vascular density and the percentage of new bone trabecula of femoral head coronary section in defect area of group C was higher than that of group B. Conclusion: Allogeneic bone marrow stromal cells cultured in vivo can form new bone trabecula, and can be applied to allotransplant. Vascular bundle implanted into the bone defect area of femoral head necrosis could improve blood supply, and promote the formation of bone trabecula.