BMP-2/VEGF双基因活化纳米骨浆对提高骨质疏松椎体强度的实验研究

摘要

目的 证明BMP-2/VEGF双基因活化纳米骨浆是椎体成形术(PVP)的理想填充材料.方法 首先构建并验证了BMP-2/VEGF双基因活化纳米骨浆构建成功,然后由生物力学测试分析注射入椎弓根和已有骨质坍塌的椎体BMP-2/VEGF双基因活化纳米骨浆后椎体的最大载荷.随后,应用双侧卵巢切除术构建山羊骨质疏松模型,研究与对照相比注射BMP-2/VEGF双基因活化纳米骨浆前和后山羊血清的碱性磷酸酶、骨钙素、最大载荷、椎体的骨密度和微观三维结构的改变.结果 BMP-2/VEGF双基因活化纳米骨浆可以明显增加椎体的最大压缩载荷和最大压缩应力明显增加(P =0.039、0.010),同时注射入已有骨质坍塌的最提椎体BMP-2/VEGF双基因活化纳米骨浆后椎体的最大压缩载荷和最大压缩应力明显增加(P ＜0.001,P=0.030);山羊骨质疏松模型中,碱性磷酸酶和骨钙素明显下降(P=0.018,P＜0.001),骨密度明显下降,骨小梁明显稀疏.注射入BMP-2/VEGF双基因活化纳米骨浆后山羊骨密度明显增加,最大压缩载荷增加(P=0.0072),最大压缩应力增加(P=0.0024);椎骨小梁更加致密,孔隙率降低.结论 本实验证明了BMP-2/VEGF双基因活化纳米骨浆是椎体成形术(PVP)的理想填充材料,可以提高椎体的骨密度和强度.%Objective To evaluate whether BMP-2/VEGF dual gene activated nanobone putty is an ideal filler for vertebroplasty (PVP).Methods Firstly,we established and validated VEGF dual gene activated nanobone putty.Then,biomechanical analysis was used to observe the maximum loading in centrum pedicle and collapsed vertebral body injected with the BMP-2/VEGF dual gene activated nanobone putty.Finally,goat bilateral oophorectomy was used to established a model of osteoporosis and explore the change in goat serum alkaline phosphatase and osteocalcin,microscopic three-dimensional structure,maximum loading and structure of the trabecular bone before and after injecting the BMP-2/VEGF dual gene activated nanobone putty compared with the negative controls.Results BMP-2/VEGF dual gene activated nanobone putty could increase the maximum loading and compression stress of the vertebral body significantly (P =0.039,0.010).The maximum loading and compression stress increased significantly in the collapsed vertebral body after injecting the BMP-2/VEGF dual gene activated nanobone putty (P ＜ 0.001,P =0.030).In the goat osteoporosis model,serum alkaline phosphatase and osteocalcin levels increased (P =0.018,P ＜ 0.001),and bone mineral density and trabeculae number reduced.Injection of the BMP-2/VEGF gene activation double putty increased bone mineral density and maximum loading (P =0.0072),maximum compression stress (P =0.024) and lowered porosity.Conclusion The study findings revealed that the BMP-2/VEGF dual gene activated nanobone putty is an ideal filler for vertebroplasty (PVP) and increases vertebral bone density.