【摘要】：目的為探索研究磁場(chǎng)技術(shù)可行的應(yīng)用加載方式,本研究以靜磁體為原件構(gòu)建用于體內(nèi)植入的靜磁體棒,明確體內(nèi)引入的內(nèi)置磁源聯(lián)合體外脈沖電磁場(chǎng)在骨及軟骨組織修復(fù)過程中的作用。方法1.根據(jù)前期在磁場(chǎng)方面的研究基礎(chǔ)和相關(guān)文獻(xiàn)報(bào)道,在生物工程領(lǐng)域?qū)＜业闹笇?dǎo)下,本研究選取磁體性能穩(wěn)定的低磁感應(yīng)強(qiáng)度釹鐵硼永磁體材料作為基本組成原件,用于構(gòu)建體內(nèi)植入多元磁棒的內(nèi)部磁極,磁極外部采用具有良好生物相容性和生物力學(xué)強(qiáng)度的醫(yī)用鈦合金材料進(jìn)行密封包被,完成內(nèi)植多元磁棒的物理屬性測(cè)定;2.內(nèi)植多元磁棒聯(lián)合脈沖電磁場(chǎng)對(duì)兔骨缺損修復(fù)的實(shí)驗(yàn)研究:選取所有實(shí)驗(yàn)新西蘭大白兔建立股骨髁骨缺損模型,依據(jù)實(shí)驗(yàn)干預(yù)方式分為聯(lián)合磁場(chǎng)組、脈沖電磁場(chǎng)組和對(duì)照組,聯(lián)合磁場(chǎng)組將內(nèi)植多元磁棒植入兔股骨干遠(yuǎn)端髓腔內(nèi),術(shù)后體外聯(lián)合脈沖電磁場(chǎng)(1h/d)進(jìn)行試驗(yàn)干預(yù),脈沖電磁場(chǎng)組和對(duì)照組分別在股骨干遠(yuǎn)端髓腔內(nèi)植入無(wú)磁鈦合金棒,同時(shí),脈沖電磁場(chǎng)組術(shù)后在體外施加脈沖電磁場(chǎng)(1h/d),各組于術(shù)后第5周取股骨遠(yuǎn)端樣本進(jìn)行大體、組織學(xué)及影像學(xué)等方面評(píng)估;3.內(nèi)植多元磁棒聯(lián)合脈沖電磁場(chǎng)對(duì)兔軟骨缺損修復(fù)的實(shí)驗(yàn)研究:選取所有實(shí)驗(yàn)新西蘭大白兔建立股骨滑車軟骨缺損模型,同樣分為聯(lián)合磁場(chǎng)組、脈沖電磁場(chǎng)組和對(duì)照組,聯(lián)合磁場(chǎng)組將內(nèi)植多元磁棒植入兔股骨干遠(yuǎn)端髓腔內(nèi),術(shù)后體外聯(lián)合脈沖電磁場(chǎng)(1h/d)進(jìn)行試驗(yàn)干預(yù),脈沖電磁場(chǎng)組和對(duì)照組分別在股骨干遠(yuǎn)端髓腔內(nèi)植入無(wú)磁鈦合金棒,同時(shí),脈沖電磁場(chǎng)組術(shù)后在體外施加脈沖電磁場(chǎng)(1h/d),各組分別于術(shù)后第4周和第10周取材進(jìn)行大體觀察、組織學(xué)及軟骨基質(zhì)成分等方面檢測(cè)。結(jié)果1.本研究中研制的用于兔股骨干遠(yuǎn)端髓腔內(nèi)植入的多元磁棒整體呈長(zhǎng)度25.0mm,直徑7.0 mm的類圓柱體,磁棒內(nèi)部由釹鐵硼永磁體和聚乙烯墊片相間排列組成,構(gòu)成磁棒內(nèi)部多元磁極,外部采用醫(yī)用鈦合金材料(Ti6Al4V)密封包被,磁棒表面磁場(chǎng)分布呈強(qiáng)弱相間變化,表面最大磁感應(yīng)強(qiáng)度為40±5 m T;2.內(nèi)植多元磁棒聯(lián)合脈沖電磁場(chǎng)對(duì)兔骨缺損修復(fù)的實(shí)驗(yàn)研究:各組于術(shù)后第5周取材,顯微CT掃描重建及組織病理學(xué)結(jié)果顯示,聯(lián)合磁場(chǎng)組外側(cè)面骨質(zhì)基本愈合完整,與周邊骨質(zhì)相延續(xù),與脈沖電磁場(chǎng)組及對(duì)照組相比,皮質(zhì)及皮質(zhì)下區(qū)域新生骨質(zhì)明顯增多,骨小梁形態(tài)及連續(xù)性較好,顯微CT骨組織定量分析結(jié)果顯示,聯(lián)合磁場(chǎng)組與對(duì)照組相比,骨缺損部位骨體積分?jǐn)?shù)及骨小梁數(shù)量明顯增加(P0.05),而骨小梁分離度下降(P0.01),骨小梁厚度無(wú)明顯統(tǒng)計(jì)學(xué)差異,而與脈沖電磁場(chǎng)組相比,聯(lián)合磁場(chǎng)組骨小梁數(shù)量增加(P0.05),骨小梁分離度下降(P0.01);3.內(nèi)植多元磁棒聯(lián)合脈沖電磁場(chǎng)對(duì)兔軟骨缺損修復(fù)的實(shí)驗(yàn)研究:大體形態(tài)方面,術(shù)后第4周,聯(lián)合磁場(chǎng)組軟骨組織修復(fù)優(yōu)于對(duì)照組(P0.05),與脈沖電磁場(chǎng)組無(wú)明顯差別(P0.05),術(shù)后第10周,聯(lián)合磁場(chǎng)組軟骨組織修復(fù)大體形態(tài)評(píng)分顯著優(yōu)于對(duì)照組(P0.01)和脈沖電磁場(chǎng)組(P0.05),組織形態(tài)方面,術(shù)后第4周,聯(lián)合磁場(chǎng)組組織形態(tài)評(píng)分明顯優(yōu)于對(duì)照組(P0.05),與脈沖電磁場(chǎng)組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后第10周,聯(lián)合磁場(chǎng)組形組織形態(tài)評(píng)分顯著優(yōu)于對(duì)照組(P0.01),與脈沖電磁場(chǎng)組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),氨基聚糖(GAG)定量比較結(jié)果顯示,術(shù)后第4周,對(duì)照組、脈沖電磁場(chǎng)組和聯(lián)合磁場(chǎng)組中所測(cè)得的GAG含量分別為:12.26±4.43μg、12.48±3.91μg和13.02±2.83μg,各組間沒有統(tǒng)計(jì)學(xué)差異;術(shù)后第10周,對(duì)照組、脈沖電磁場(chǎng)組和聯(lián)合磁場(chǎng)組中所測(cè)得的GAG含量分別為:15.54±3.66μg、20.45±2.9μg和19.84±2.21μg,脈沖電磁場(chǎng)組和聯(lián)合磁場(chǎng)組GAG含量明顯高于對(duì)照組(P0.05),聯(lián)合磁場(chǎng)組和脈沖電磁場(chǎng)組兩者間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論本研究以永磁體為基本組成原件構(gòu)建的低磁感應(yīng)強(qiáng)度可植入多元磁棒作為體內(nèi)磁源,與體外脈沖電磁場(chǎng)共同構(gòu)成聯(lián)合磁場(chǎng),聯(lián)合磁場(chǎng)作用方式在相同組織創(chuàng)傷條件下相對(duì)單一脈沖電磁場(chǎng)及對(duì)照組具有更好的促進(jìn)骨質(zhì)形成,改善骨顯微結(jié)構(gòu)的作用,同時(shí)能夠增強(qiáng)關(guān)節(jié)軟骨的早期形態(tài)修復(fù)和界面整合,提高軟骨組織中氨基聚糖基質(zhì)成分的合成,本研究結(jié)果初步證實(shí)了內(nèi)植磁場(chǎng)作用方式的可行性,對(duì)于局部靶向磁場(chǎng)治療以及遠(yuǎn)期骨科植入材料的附磁應(yīng)用等方面具有重要研究?jī)r(jià)值。
[Abstract]:Objective In order to explore a feasible loading method of magnetic field technology, magnetostatic rods for in vivo implantation were constructed with magnetostat as the original material, and the role of in vivo magnetic source combined with in vitro pulsed electromagnetic field in bone and cartilage tissue repair was clarified. Methods 1. According to the previous research foundation and related papers on magnetic field. Under the guidance of experts in the field of bioengineering, Nd-Fe-B permanent magnets with stable magnetic properties were selected as the basic components to construct the internal magnetic poles of multicomponent magnetic rods implanted in vivo. The external magnetic poles were made of medical titanium alloy materials with good biocompatibility and biomechanical strength. The physical properties of the implanted multivariate magnetic rods were measured by sealed coating. 2. The experimental study of implanted multivariate magnetic rods combined with pulsed electromagnetic field for repairing bone defects in rabbits: All experimental New Zealand white rabbits were selected to establish the femoral condyle defect model. According to the experimental intervention methods, they were divided into combined magnetic field group, pulsed electromagnetic field group and control group, combined magnetic field group. Pulsed electromagnetic field group and control group were implanted non-magnetic titanium alloy rods in the distal femoral shaft medullary cavity of rabbits respectively. Pulsed electromagnetic field group was implanted non-magnetic titanium alloy rods in the distal femoral shaft medullary cavity of rabbits after operation. Pulsed electromagnetic field group was applied in vitro after operation (1h/d). The femurs of each group were harvested at the 5th week after operation. The distal bone samples were grossly, histologically and radiologically assessed; 3. Experimental study of cartilage defect repair with implanted multivariate magnetic rods combined with pulsed electromagnetic field in rabbits: All experimental New Zealand white rabbits were selected to establish the femoral trochlear cartilage defect model, which was also divided into combined magnetic field group, pulsed electromagnetic field group and control group. Pulsed electromagnetic field group and control group were implanted non-magnetic titanium alloy rods in the distal femoral shaft medullary cavity of rabbits. Pulsed electromagnetic field group and control group were implanted non-magnetic titanium alloy rods in the distal femoral shaft medullary cavity of rabbits. Pulsed electromagnetic field group were applied in vitro after operation (1h/d). Each group was at the 4th week and 10th week after operation, respectively. Results 1. The multicomponent magnetic rods for implantation in the medullary cavity of the distal femoral shaft of rabbits were cylindrical-like with a length of 25.0 mm and a diameter of 7.0 mm. The magnetic field distribution on the surface of the magnetic rod changed between strong and weak phases. The maximum magnetic induction intensity was 40 The results showed that the external bone of the combined magnetic field group basically healed completely and continued with the peripheral bone. Compared with the pulsed electromagnetic field group and the control group, the cortical and subcortical bone regeneration increased significantly, and the trabecular bone morphology and continuity were better. The quantitative analysis of the bone tissue of the combined magnetic field group and the control group showed that the bone defect site was more than that of the combined magnetic field group. Bone volume fraction and trabecular bone number increased significantly (P 0.05), but trabecular bone segregation decreased (P 0.01). There was no significant difference in trabecular bone thickness. Compared with pulsed electromagnetic field group, the number of trabecular bone increased (P 0.05) and trabecular bone segregation decreased (P 0.01) in combined magnetic field group. The gross morphology of cartilage repair in the combined magnetic field group was better than that in the control group (P 0.05) at the 4th week after operation, and there was no significant difference between the combined magnetic field group and the pulsed electromagnetic field group (P 0.05). At the 10th week after operation, the gross morphology score of cartilage repair in the combined magnetic field group was significantly better than that in the control group (P 0.01) and the pulsed electromagnetic field group (P 0.05). At the fourth week, the combined magnetic field group was significantly better than the control group (P 0.05), and there was no significant difference between the combined magnetic field group and the pulsed electromagnetic field group (P 0.05). At the tenth week, the combined magnetic field group was significantly better than the control group (P 0.01), and there was no significant difference between the combined magnetic field group and the pulsed electromagnetic field group (P 0.05). The results showed that GAG levels in control group, pulse electromagnetic field group and combined magnetic field group were 12.26 65507 The content of GAG in pulsed electromagnetic field group and combined magnetic field group was significantly higher than that in control group (P 0.05), and there was no significant difference between the combined magnetic field group and pulsed electromagnetic field group (P 0.05). Electromagnetic field combined with magnetic field can promote bone formation and improve bone microstructure better than single pulse electromagnetic field and control group under the same tissue trauma condition. At the same time, it can enhance the early morphological repair and interface integration of articular cartilage and improve the aminoglycan matrix in cartilage tissue. The results of this study preliminarily confirm the feasibility of the mode of action of implanted magnetic field, and have important research value for local targeted magnetic field therapy and long-term magnetic attachment application of orthopedic implants.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R68

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