發(fā)布時間：2018-05-17 22:10

  本文選題：孔徑 + 孔隙結(jié)構(gòu)��； 參考：《第四軍醫(yī)大學(xué)》2012年碩士論文

【摘要】：研究背景：各種原因引起的骨缺損的修復(fù)一直是骨科界所面臨的難題。以往常采用異體骨移植的方法來修復(fù)骨缺損，但異體移植骨來源有限，而且易產(chǎn)生免疫排斥反應(yīng)。隨著組織工程學(xué)迅速發(fā)展，利用骨組織工程學(xué)的方法修復(fù)骨缺損成為一種全新的治療模式，具有廣闊的應(yīng)用前景。支架材料、種子細胞、誘導(dǎo)因子為骨組織工程研究的三要素，而支架材料又是其基礎(chǔ)環(huán)節(jié)。相關(guān)研究表明，材料的自身結(jié)構(gòu)是影響材料機械性能和生物學(xué)性能的一項重要的形態(tài)學(xué)特性，是支架材料設(shè)計與選擇所要考慮的重要因素之一；材料的結(jié)構(gòu)參數(shù)包括孔型、孔徑、孔隙率和連通性等等；其中材料孔徑的大小對于細胞的增殖和黏附、新生骨組織形成等都有著重要的影響。因此，研究者們一直在探索有利于骨組織構(gòu)建的最佳孔徑大小。但是，至今為止，對于支架材料的最佳孔徑選擇仍然存在爭論。本課題的前期實驗結(jié)果顯示不同孔徑材料在非骨環(huán)境和松質(zhì)骨缺損中誘導(dǎo)形成的新生骨組織在分布和數(shù)量上有明顯差異的。本研究擬通過采用孔隙率相同、孔徑不同的(200-300μm、300-450μm、450-600μm)的CPC材料修復(fù)兔大段骨缺損，評價不同孔徑的CPC材料的骨缺損修復(fù)能力，從而篩選出適合的孔徑，以期達到成骨能力與生物力學(xué)性能的良好統(tǒng)一,為未來臨床應(yīng)用提供科學(xué)依據(jù)。 研究目的：探討多孔磷酸鈣骨水泥（CPC）孔徑大小對其骨缺損修復(fù)能力的影響。 研究方法：采用鹽析法制備了孔隙率相同（68.3±3.3%）、孔型較均一的三種不同孔徑的(200-300μm、300-450μm、450-600μm)多孔CPC材料，將三種不同孔徑的材料分別植入兔大段橈骨缺損模型，術(shù)后4、12、24周分別進行大體觀察、X線檢查、血清堿性磷酸酶（ALP）檢測、組織學(xué)觀察和生物力學(xué)檢測。 研究結(jié)果：術(shù)后12周X線檢查可見200-300μm孔徑材料骨缺損區(qū)形成的骨痂較多,4、24周時X線檢查結(jié)果各組差異不明顯；4周時血清ALP檢測200-300μm材料組高于其它組，差異具有統(tǒng)計學(xué)意義（P0.05），12、24周ALP檢測三組差異無統(tǒng)計學(xué)意義；12周組織形態(tài)計量學(xué)分析顯示200-300μm材料組新生骨的面積百分比最多，差異有統(tǒng)計學(xué)意義（P0.05），24周組織形態(tài)計量學(xué)分析結(jié)果提示，三組材料內(nèi)新生骨面積百分比均增高，但差異無統(tǒng)計學(xué)意義（P0.05）；力學(xué)結(jié)果顯示12周時200-300μm組材料的最大壓縮載荷和彈性模量均好于其它兩組（P0.05），24周時各組測得的最大壓縮載荷和彈性模量差異不具有統(tǒng)計學(xué)意義。 研究結(jié)論：孔徑的大小可以影響骨生物材料在體內(nèi)的成骨性能，本研究中小孔徑材料在早期更利于成骨，，且更易達到成骨性能和力學(xué)性能的統(tǒng)一；而在晚期，不同孔徑的材料在骨缺損內(nèi)的成骨數(shù)量無顯著差異，且材料植入?yún)^(qū)的力學(xué)強度無顯著差異。
[Abstract]:Background: repair of bone defects caused by various causes has been a difficult problem in orthopedics. Allogeneic bone graft was used to repair bone defect, but allograft bone was limited in origin and prone to immune rejection. With the rapid development of tissue engineering, the method of bone tissue engineering to repair bone defects has become a new treatment mode and has a broad application prospect. Scaffold materials, seed cells and inducing factors are the three elements of bone tissue engineering, and scaffold materials are the basic link of bone tissue engineering. Related studies have shown that the structure of the material is an important morphological characteristic that affects the mechanical and biological properties of the material, and is one of the important factors to be considered in the design and selection of the scaffold material, and the structural parameters of the material include the pore shape. Pore size, porosity, connectivity and so on. The pore size of materials has an important effect on cell proliferation and adhesion, new bone tissue formation and so on. As a result, researchers have been exploring the optimal pore size for bone tissue construction. However, up to now, there is still controversy about the optimum pore size choice of scaffold materials. The experimental results show that the distribution and number of new bone tissue induced by different pore size materials in non-bone environment and cancellous bone defect are significantly different. The aim of this study was to evaluate the ability of repairing large segments of bone defects of rabbits by using CPC materials with the same porosity and different pore sizes (300-450 渭 m ~ 450-600 渭 m), so as to screen out the appropriate pore size. In order to achieve a good unity of osteogenic ability and biomechanical properties, and provide scientific basis for clinical application in the future. Objective: to investigate the effect of pore size of porous calcium phosphate cement (CPC) on the ability of repairing bone defect. Methods: three kinds of porous CPC materials with the same porosity (68.3 鹵3.3%) and uniform pore sizes (200-300 渭 m ~ 450 渭 m ~ 450-600 渭 m) were prepared by salt-out method. Three kinds of porous CPC materials with different pore sizes were implanted into rabbit radial defect model. Gross observation X-ray examination, serum alkaline phosphatase (ALP) detection, histological observation and biomechanical examination were performed 24 weeks after operation. Results: X-ray examination at 12 weeks after operation showed that 200-300 渭 m radius material bone defect area formed more callus at 24 weeks. The results of X-ray examination showed no significant difference in 24 weeks after operation. At 4 weeks, serum ALP detection of 200-300 渭 m material group was higher than that of other groups. The difference was statistically significant (P 0.05). There was no significant difference in 24 weeks ALP detection among the three groups. The histomorphometry analysis showed that the area percentage of new bone was the largest in the 200-300 渭 m group at the 12th week, and the difference was statistically significant. The results of 24 weeks histomorphometry analysis suggested that there was no significant difference between the two groups. The percentage of new bone area increased in all three groups. The mechanical results showed that the maximum compression load and elastic modulus of 200-300 渭 m group were better than those of the other two groups at 24 weeks. Conclusion: the size of pore size can affect the osteogenic properties of bone biomaterials in vivo. In this study, small pore size materials are more conducive to osteogenesis in the early stage, and more easy to achieve the unity of osteogenic and mechanical properties. There was no significant difference in the amount of osteogenesis in the bone defect between the materials with different pore sizes, and there was no significant difference in the mechanical strength of the implant area.
【學(xué)位授予單位】：第四軍醫(yī)大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R318.08

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