骨基质明胶复合自体外周血干细胞修复骨缺损的安全性评价

背景：动物实验证实骨基质明胶移植后免疫排斥反应小,可在早期促进软骨及骨形成。目的：观察骨基质明胶吸附自体外周血干细胞修复骨缺损的可行性。方法：将节段性骨缺损病例患者按照自愿原则分2组治疗,一组将自体外周血干细胞/骨基质明胶充分嵌合于骨断端,另一组仅将骨基质明胶嵌合于骨断端,并行牢固内外固定。术后拍摄骨缺损部位正、侧位X射线片。结果与结论：自体外周血干细胞/骨基质明胶组骨折端可见大量新生不规则骨纤维组织、软骨及纤维骨痂填充,可见骨细胞、骨组织和骨小梁,已形成骨髓腔。骨基质明胶组骨折端可见大量纤维组织、少量新生不规则骨纤维组织及骨骼肌组织,伴有多核巨细胞和少量炎性细胞,缺损区边缘带有骨痂组织。自体外周血干细胞/骨基质明胶组术后愈合时间较骨基质明胶组缩短（P〈0.05）;治疗期间患者未见明显不良反应。说明自体外周血干细胞/骨基质明胶具有良好的生物相容性和可吸收性,在骨缺损愈合过程中起骨引导和骨诱导作用,效果优于单纯骨基质明胶移植。

Safety evaluation of bone matrix gelatin with autologous peripheral blood stem cells to repair bone defects

BACKGROUND： Animal experiments confirmed that the immunological rejection of bone matrix gelatin （BMG） is small after transplantation and BMG can promote cartilage and bone formation in the early stage. OBJECTIVE： To study the feasibility of repairing segmental bone defects by autologous peripheral blood stem cells （APBSC）/BMG. METHODS： The patients with bone defect were divided into 2 groups in accordance with the principle of voluntary. APBSC/BMG group： APBSC/BMG was installed in the bone ends, BMG group： BMG was installed in the bone ends. In addition, external and internal fixations were performed. The positive and lateral X-ray films of the bone defect were taken after surgery. RESULTS AND CONCLUSION： In APBSC/BMG group, a great amount of new irregular bone fibrous tissues, cartilage, bone cells, bone tissues and bone trabeculae are on the surface of fracture end, with medullary cavity formed. In BMG group, a great amount of fibrous tissues, a less of new irregular bone fibrous tissues and skeletal muscles were seen on the surface of fracture, accompanied by multinucleated giant cells and a few inflammatory cells. Bony callus tissues were observed at the edge of defect area. The average cicatrization time of APBSC/BMG group was shorter than BMG group （P 0.05）. There were no obvious adverse reactions found during the treatment. APBSC/BMG has good biocompatibility, absorbability and bone induction in the process of bone defect healing. The effect of APBSC/BMG is better than BMG.