本文選題：骨髓間充質(zhì)干細(xì)胞 + 富白細(xì)胞及血小板纖維凝膠�。� 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的從世界范圍的研究來看,股骨頭缺血性壞死發(fā)病率較高,非手術(shù)的保髖治療和早期的手術(shù)干預(yù)治療療效各異,最終目的為延緩股骨頭壞死的進(jìn)程,推遲或者避免全髖關(guān)節(jié)置換手術(shù)。富白細(xì)胞和血小板纖維蛋白(leucocyte and platelet-rich fibrin L-PRF),為新一代的血液濃縮制品,能提供生理性的三維支架,各種豐富的生長因子和抗炎作用的富白細(xì)胞。骨髓間充質(zhì)干細(xì)胞(Bone marrow mesenchymal stem cells BMSCs)為成骨種子細(xì)胞,能促進(jìn)新骨形成和促進(jìn)血管源性生長。本研究通過建立早期股骨頭缺血性壞死兔模型并探討富白細(xì)胞和血小板纖維蛋白凝膠在治療早期兔股骨頭缺血性壞死對BMSCs成骨分化作用的影響。方法4~6月齡新西蘭大白兔48只,體重2.0~3.0kg,雌雄不拘。隨機分成A、B、C、D 4組(n=12),每只兔實驗前,于心跳最強處抽血,離心,靜置,棄上清液和底層的紅細(xì)胞,取中間富白細(xì)胞和血小板纖維蛋白凝膠。取兩側(cè)髂后上嵴處穿刺抽取骨髓,培育骨髓間充質(zhì)干細(xì)胞并鑒定,液氮冷凍建立雙側(cè)ANFH模型。A組:單純行髓芯減壓;B組:髓芯減壓聯(lián)合L-PRF移植;C組:髓芯減壓聯(lián)合BMSCs移植;D組:髓芯減壓聯(lián)合BMSCs及L-PRF移植。術(shù)后4、8、12周,攝X線片,觀察髖關(guān)節(jié)和骨缺損灶骨密度變化,并行Lane-Sandhu X線片評分評價成骨情況;取各組股骨頭標(biāo)本,行組織學(xué)觀察及血管計數(shù)、新生骨面積百分比。結(jié)果富白細(xì)胞和血小板纖維蛋白凝膠為半透明白色凝膠狀。骨髓間充干細(xì)胞為梭形單核細(xì)胞。影像學(xué)X射線評分情況組織學(xué)血管計數(shù)、新生骨面積百分比,第4、8、12周時,C、D組優(yōu)于A、B組,D組優(yōu)于C組,B組優(yōu)于A組,各組間的差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論在股骨頭缺血性壞死的兔模型中,通過髓芯減壓,使用新一代血液制品富白細(xì)胞和血小板纖維蛋白凝膠聯(lián)合骨髓間充質(zhì)干細(xì)胞對成骨的影響,比單一應(yīng)用富白細(xì)胞和血小板纖維蛋白或骨髓間充質(zhì)干細(xì)胞對成骨作用更加明顯,為今后臨床治療股骨頭缺血性壞死打下理論基礎(chǔ)。
[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.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.8

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 Joaquin Moya-Angeler;Arianna L Gianakos;Jordan C Villa;Amelia Ni;Joseph M Lane;;Current concepts on osteonecrosis of the femoral head[J];World Journal of Orthopedics;2015年08期

2 方家劉;尹宗生;王偉;陸鳴;江正;高維陸;張碩;余濤;;富白細(xì)胞和血小板血漿對BMSCs在兔股骨頭缺血性壞死中成骨作用的影響[J];中國修復(fù)重建外科雜志;2015年02期

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本文編號：1926724