摘要
目的 :探讨不同海拔对兔大段骨缺损修复时再血管化的影响。方法 :分别在青海大武(海拔 3719m)、西宁 (海拔 2 2 6 0m)和重庆 (海拔 347m) ,采用当地家兔制成单侧桡骨缺损不愈合的模型 ,局部应用由脱钙骨基质骨粒、骨水泥、自体红骨髓和医用生物膜制成的复合材料。术后 2周、4周、8周用单光子放射计算机断层显像术 (single photonemissioncomputerizedtomography ,SPECT)测定骨缺损局部的血流量变化 ,组织学观察缺损区骨痂生长和血管植入情况。结果 :SPECT显示 ,在愈合早期 (2W )各组间的血流量无明显差异 (P >0 .0 5 ) ,而在骨折愈合晚期 (4W ,8W )随着海拔的升高 ,骨缺损局部血流量逐渐减少 ,各组间的血流量差别有显著性 (P <0 .0 1)。组织学检查 :重庆组和西宁组术后 8周骨痂外层为板层骨 ,中央为编织骨 ,内有骨髓组织 ,复合材料微孔内有大量新生血管植入 ,而大武组的缺损区骨痂大多为软骨组织和纤维组织 ,复合材料的微孔内仅有少量血管植入。结论 :高海拔缺氧对骨缺损修复时再生血管的植入有明显的影响 。
Objective:To study the effects of hypoxia on revascularization in the process of repair of rabbits long bone defect at high altitude. Methods: The experiments were conducted in Qinghai Dawu(3 719m),Xining(2 260m)and Chongqing(347m) respectively. A 15mm defect model was made in middle-superior segment of rabbet's radius. Then the composite materials were implanted to the bone defect sites respectively, the composition of Co-materaiale include of decalcified bone matrix (DBM), bone cement (BC) and autologous red marrow (RM) enveloped with collagen membrane. The blood flow at the bone defect was assayed by SPECT (single photon emission computerized tomography), the composition of callus and revascularization at the bone defect sites were observed by histological methods in 2,4,8 weeks after operation.Results:No significant difference were found in the early repair period in terms of blood flow at the bone defect sites (P>0.05), While differences were found in the later period (4W, 8W) (P<0.01). The blood flow was decreased gradually along with altitude increased at a certain period. Histologically, by 8weeks, defect sites in Chongqing and Xining experiment group were bridged by lamellar bony callus, the compact bone was seen in the outside of callus, the medullary cavity in the centre and a great deal of new capillary vessels implantated in the DBM/BC/RM composite material. Whereas, in the Dawu group, defect sites were filled chondrocyte and connective tissue. And a few angiogenesis in the DBM/BC/RM. Conclusion: High altitude hypoxia effected revascularization in the process of repair of bone defect, and maybe as an important factor on dys-repair of bone defect in the high altitude areas.
出处
《高原医学杂志》
CAS
2004年第4期7-10,F004,共5页
Journal of High Altitude Medicine
关键词
骨缺损
修复
血流量
再生血管
高海拔
兔
Bone defect
Repair
Blood flow
Revascularization
High altitude Rabbits
