富白细胞及血小板纤维蛋白凝胶对BMSCs在兔股骨头缺血性坏死中成骨作用的影响

发布时间：2018-05-23 22:59

本文选题：骨髓间充质干细胞 + 富白细胞及血小板纤维凝胶　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的从世界范围的研究来看,股骨头缺血性坏死发病率较高,非手术的保髋治疗和早期的手术干预治疗疗效各异,最终目的为延缓股骨头坏死的进程,推迟或者避免全髋关节置换手术。富白细胞和血小板纤维蛋白(leucocyte and platelet-rich fibrin L-PRF),为新一代的血液浓缩制品,能提供生理性的三维支架,各种丰富的生长因子和抗炎作用的富白细胞。骨髓间充质干细胞(Bone marrow mesenchymal stem cells BMSCs)为成骨种子细胞,能促进新骨形成和促进血管源性生长。本研究通过建立早期股骨头缺血性坏死兔模型并探讨富白细胞和血小板纤维蛋白凝胶在治疗早期兔股骨头缺血性坏死对BMSCs成骨分化作用的影响。方法4~6月龄新西兰大白兔48只,体重2.0~3.0kg,雌雄不拘。随机分成A、B、C、D 4组(n=12),每只兔实验前,于心跳最强处抽血,离心,静置,弃上清液和底层的红细胞,取中间富白细胞和血小板纤维蛋白凝胶。取两侧髂后上嵴处穿刺抽取骨髓,培育骨髓间充质干细胞并鉴定,液氮冷冻建立双侧ANFH模型。A组:单纯行髓芯减压;B组:髓芯减压联合L-PRF移植;C组:髓芯减压联合BMSCs移植;D组:髓芯减压联合BMSCs及L-PRF移植。术后4、8、12周,摄X线片,观察髋关节和骨缺损灶骨密度变化,并行Lane-Sandhu X线片评分评价成骨情况;取各组股骨头标本,行组织学观察及血管计数、新生骨面积百分比。结果富白细胞和血小板纤维蛋白凝胶为半透明白色凝胶状。骨髓间充干细胞为梭形单核细胞。影像学X射线评分情况组织学血管计数、新生骨面积百分比,第4、8、12周时,C、D组优于A、B组,D组优于C组,B组优于A组,各组间的差异有统计学意义(P0.05)。结论在股骨头缺血性坏死的兔模型中,通过髓芯减压,使用新一代血液制品富白细胞和血小板纤维蛋白凝胶联合骨髓间充质干细胞对成骨的影响,比单一应用富白细胞和血小板纤维蛋白或骨髓间充质干细胞对成骨作用更加明显,为今后临床治疗股骨头缺血性坏死打下理论基础。
[Abstract]:Objective from the worldwide study, the incidence of avascular necrosis of femoral head is high, the curative effect of non-operative hip preservation therapy and early operative intervention is different, and the ultimate aim is to delay the progress of femoral head necrosis. Postpone or avoid total hip replacement. Leucocyte and platelet-rich fibrin L-PRFN, which is rich in leukocyte and platelet fibrin, is a new generation of blood concentrate, which can provide physiological three-dimensional scaffold, various growth factors and anti-inflammatory rich leukocyte. Bone marrow mesenchymal stem cells (BMSCs) are osteoblast seeded cells, which can promote the formation of new bone and promote angiogenic growth. In this study, the rabbit model of early avascular necrosis of femoral head was established and the effects of leukocyte rich and platelet fibrin gel on osteogenesis differentiation of BMSCs were studied in the treatment of early avascular necrosis of femoral head. Methods 48 New Zealand white rabbits aged 4 to 6 months, weighing 2.0 ~ 3.0 kg, were male and female. Each rabbit was randomly divided into two groups: group A, B, C, D _ 4. Before the experiment, blood was drawn from the strongest heart beat, centrifuged, resting, supernatant and bottom red blood cells were discarded, and fibrin gels were extracted from the middle white blood cells and platelets. Bone marrow was extracted from bilateral posterior superior iliac crest, bone marrow mesenchymal stem cells were cultured and identified. Bilateral ANFH model was established by liquid nitrogen cryopreservation. Group A: simple core decompression group B: core decompression combined with L-PRF transplantation group C: core decompression combined with BMSCs transplantation group D: core decompression combined with BMSCs and L-PRF transplantation. The bone mineral density (BMD) of hip joint and bone defect was observed, and the osteogenesis was evaluated by Lane-Sandhu radiography, and the femoral head specimens were taken for histological observation and blood vessel count, and the percentage of new bone area. Results Leukocyte-rich and platelet-rich fibrin gels were translucent white gels. Bone marrow mesenchymal stem cells are fusiform monocytes. The histological blood vessel count, the percentage of bone area and the percentage of bone area were better in group D than in group C and group C at the 12th week of the 8th week. The difference between the two groups was statistically significant (P0.05P < 0.05), and that of group D was better than that of group C (P < 0.05), but that of group B was better than that of group C (P < 0.05). Conclusion in the rabbit model of avascular necrosis of femoral head, the effect of bone marrow mesenchymal stem cells combined with leukocyte rich in blood products and platelet fibrin gel on osteogenesis was observed by core decompression. The effect of leukocyte rich, platelet fibrin or bone marrow mesenchymal stem cells on osteogenesis was more obvious than that of leukocyte rich and platelet-rich fibrin or bone marrow mesenchymal stem cells.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.8

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